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Guess House Affidavit
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT Building and Code Regulations Division 2300 VIRGINIA AVE FORT PIERCE, FL 34982 772-462-1553 GUEST HOUSE AFFIDAVIT I hereby affirm that Building Permit # 1 3 o I — e)© IT 1 is to be issued for a guest house which will not be used for rental purposes, seasonally or annually, under any circumstances. 6 4,[ 92� B 36 V9,)7— Print Owner's Name Signa ure of Owner V C STATE OF COUNTY OF The foregoing instrument was ackno ledged before me this 0 day of Se'E 20 1 by " ice{ vLQ T ,w 0l personally known to me () or who has pi oduced as identification. Notary Stamp CEO SEA' 3 P; Wl wORKs SLCPDSD Revised 08/24/2010