HomeMy WebLinkAboutElevation AffidavitBOARD OF
COUNTY
COMMISSIONERS
Elevation Affidavit
Date 32 Z6 / `
PLANNING &
DEVELOPMENT
SERVICES
DEPARTMENT
Building and Code
Regulation Division
Property Address
Permit #
Flood Zone
The non -habitable / non-residential building (accessory structure) cannot be
converted to a habitable dwelling unit unless it is modified with a building permit
to comply with the relevant elevation requirement.
Print Owner's Name
STATE OF FLORIDA
COUNTY OF j [_ � q r: e _
Signature of Owner
The fo going insment was acknowledged before me this ? S day of ,//I,, /C 6 , 20
by _�,- 1 : ; - > ' personally known to me or who has produced
as identification.
tgnature of Public
Commission Number
Joseph Gomez
Commission # GG161404
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Expires: November 16, 2021
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Bonded thru Aaron Notary
1111110
website: www.sflucieco.aov
2300 Virginia Avenue - Fort Pierce, FL, 34982-5652
Phone (772) 462-1553 FAX (772) 462-1578