HomeMy WebLinkAboutElevation AffidavitPLANNING & DEVELOPMENT
BOARD OF �' SERVICES DEPARTMENT
COUNTY i
COMMISSIONERS o ,D Building and Code Regulation
Division
Elevation Affidavit
Date .J u
Property Address �j
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.
Al-F."4 29 CL
Print Owner's Name
STATE OF FLORIDA
COUNTY OF
s
gnatur f Owner
The f reto i cnt was acknowledged before me this day of�,,,Ih
20z
by'[ f 0 d S personally lrnown to me uced
as identification.
Number
Notary Pubic Stag of Fbdda
David C �y MyOWNGSWGO 121034
�14 w FROM 011130 A21
1 JC Virginia Avenue- mart Pierce, FL. 34982-5652
Phone (772)462.1553 FAX (772) 462-1576