HomeMy WebLinkAboutELEVATION AFFIDAVITBOARD OF
COUNTY
COMMISSIONERS
Elevation Affidavit
Date
PLANNING &
DEVELOPMENT
SERVICES
DEPARTMENT
Building and Code
Regulation Division
Property Address Z 1 Z Col, �n e Gad r it Pt ��� � f � 3 Y 9 Ys
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.
J-asoh SeIP4
Print Owner's Name
STATE OF FLORIDA
COUNTY OF Sk . Irecta e
gnature of Owner _-Z'
The foregoing instrument was acknowledged before me this day of e.S' 20 011
by �_asoA y � personally known tome or who has produced
as identification.
G G a63o r a- .4, ,u JESSICAHERNANDEZ
Commission Number .; Commission#GG263092
ExPIMS September 27, 2022
TIN TWyF*hsur =8*3&r7018
Website: www.stiudeeD.aov
2300 Virginia Avenue - Fart Pierce, FL 34982-5652
Phdhe (772) 462-1553 FAX (772) 4624578