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Residential Roof Dry-In Affidavit
8t Lucie County, Public Works Department
Code Compliance Division
Owner's Address
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Building Permit #
Owner's Name
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Contractor
Contractor's Address
I certify that: The required Lapping and Fasteners of the underlayment
(roof felt) and flashing have been installed in accordance with Chapter
15 of the Florida Building Code and Chapter 9 of the Florida Building
Code, Residential with approved revisions and meet the requirements of
the product approval.
I understand that by executing this Affidavit I hereby relieve St Lucie
County of any liability with respect to the installation of these materials.
OWNER/CONTRACTOR'S SIGNATURE
HOMEOWNER'S SIGNATURE
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this _ day of , 20 _, by
, who is personally
known to me or who has produced
as identification.
The foregoing instrument was acknowledged
before me this _ day of , 20 _, by
, , who is personally
known to me or who has produced
as identification.
Signature of Notary
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Signature of Notary
Type or Print Name of Notary
Type or Print Name of Notary
Commission No.
(Seal)
Commission No.
(Seal)
No Faxed Copies, Only Original Notarized Copy will be accepted.
dmg revised 12/22/2006