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<br />~ St!11 <br /> <br />CIiED.lOCT 29 2003 2:00 T.! :58/i\0. 6343515<192 P 3 <br /> <br />OWNER <br />RECONSTRUCTIONIIMPROVEMENT AFFIDAVIT <br /> <br />Parcel 10 No.: '0 . ~(o ~\ _ ~<:) . COloo _ OO\:)\J <br /> <br />P....ny Addft..: S" g 2.q ~Pl'-I -h>rJ s,\- ~ <br /> <br />Contractor Name: :B C"- ~ P\ ~ \.' ~{ (. r Ucense No.: ~,<:.. o\fq 3Co ') <br /> <br />awr.o, Name:l> e W1>I\I-c:... ~t""~ S <br /> <br />Address: s~"lf l)~on ~ Tel.pnon,-_ jj3- r82-- ~J33 <br /> <br />I hereby attest to the f:act th:a the repalrSlreconstruction ana/or remodeling list SUbmitted kern the Substantial <br />Oamlloeilmprovement Review Oy my comraCl:or are ALL OF THE DAMAGESllMPROVEMENT5 SUStaIned ~y <br />this struc:t~r~ and will be done to the eXIsting CUlkling. and that all additions. ImprOVements. or repaIrs en the <br />sUbjed bUIlding are ,"cluded In this eStlmatea con.truction herewith. No other cantractor ha. made any repairs <br />ar recon8trul:tiOn or additions or remodeling not jnc.uded in the attached list. <br /> <br />ll.81derstand that I arn subject to enforcement action andJor fines if inspection of the proPert'( "",eals that I have <br />mid. repairs ar Improvements NOT lNCLUOEC ON THE A TTACHEO LIST OF REPAIRS TO MY HOMe. or tnal <br />I have ind1.lded noncanfomul"Ig or illegal strudurelladditJons te the existing structure without havinli presentee <br />plana fQl' :such additions. I undet!tand that any pennit iSSUed by Pasea County pursuant to this affidavit does no: <br />adi'lonze the recanstNeticn. reg.lf or maintenance of any ill.gal addition.. fenees. sheds. or nancantonning uu. <br />or structures en the sUOject Dropeny. <br /> <br />STATE OF ~o<-,.~~ <br />COUNTY OF ~C,...C:) <br /> <br />aefore me this day personallv appeared who, being dUly awo. <br />dllposes and says tn3t he has react understand,. and agrees to comply with aU ot tl1e aforementioned CDrlditAons <br />? <br />~A~A' _~ err <br />SIgnature Owner <br /> <br />Co-oWner <br /> <br />~~ <br />2#-s~o ~ . - <br /> <br />Swom to IInd SCJbscriblJd before me this <br /> <br />d.., of <br /> <br />My commisaion expires <br /> <br />.. ~.c~-:,;,:~8{1:> * <br />d}, ,.. <br />"~OFF\.r1'<;j <br /> <br />MONA L. BUllER <br />MY COMMISSION # CC 961647 <br />EXPIRES: AuguSl16. 2004 <br />Bonded TnfU Budget Notary Services <br />