HomeMy WebLinkAboutLori Kandill Electrical AffidavitDI J j JJUL'
Electrical Affidavit
sT. LUCIE WORKS
Date - d
Parcel ID #
Address
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 in violation of
the LDC
• Renting or leasing any portion of the accessory structure in violation of the LDC
• Converting accessory structure into additional occupied or living space in violation of
the LDC
I fully understand that if the condition of this affidavit is broken without consent, power could
be shut off to the building without notice.
tint Owner's Name CM- : ature of Owne
STATE OF FLORIDA, COUNTY
CP
SWORN TO (OR AFFIRMED) AND SUBSCRIBED BEF RE ME OF PHYSICAL PRESENCE
ONLINE NOTORIZATION THIS P,� DAY OF 20 0
NAME OF PERSON MAKING PSTTEMENT
PERSONALLY KNOWN OR PRODUCED IDENTIFICATION
PLANNING & DEVELOPMENT SERVICES I BUILDING DIVISION
Ir 2300 Virginia Avenue I Fon Pierce, FL 34982 % (772) 467 - 1581 8 (7721462 - 1428 0 (772) 462 - 1581 ® www.silurieco gov