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Electrical Affidavit
Date 1 G 34 l
ST. LUCIE
Parcel ID #, — 530 ' — mcs — 3
Address c Ve yo—Tr h LuckeT-L 3UlWl ,
Permit #
I have requested to install an additional electric service/meter at the above named property. By
signing this affidavit, I fully agree that the additional electrical service/meter-does not allow for
the following:
• Operation of a business venture or entity within the accessory structure
• Renting or leasing any portion of the accessory structure
• Converting accessory structure into additional occupied or living space
I fully understand that if the conditions of
off to the building without notice.
Print Owner's pia e
STATE OF FLORIDA, COUNTY OF
is affidavit is found ' vi
/ J
gnature of Owner
power may be shut
SWORN TO (OR AFFIRMED) AND SUBSCRIBED BEFORE ME OF �< PHYSICAL PRESENCE OR
ONLINE NOTORIZATION THIS DAY OF J-L1NVC1QZO
NAME OF PERSON MAKING STATEMENT
PERSONALLY KNOWN OR PRODUCED IDENTIFICATION ,---
TYPE OF IDENTIFICATION PRODUCED L_
SIG A RE OF NOTARY KrdLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER KRYSTAL RODRIG,Ic? OTERO
? Notary Public -St -,,.to ;f Florida
F-
Hy SEAL) += Commission #.-IH 89764
KRYSTAL RODRIGUEZ OTERO -' My Commi55i;:;Expires
Notar Public -State of FlorldefyFebruary Ou, �t? 25
Commission # H89764My Commission Expirpg
February08,2025
PLANNING & DEVELOPMENT SERVICES I BUILDING DIVISION
2300 Vu�,-mli l I gut Pi,!icc 1 1 14982 C► (772)40, - 1551 T t-721 462 - I428 i7„1 dh_ - 1 �78