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04/23/2007 02:08 7724521735
ST LUCIE CO
PAGE 01
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Residential Roof l,ry-In Affidavit
St Lucie County, Public Works Department
Code Compliance Division
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Building Perinit #
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APR 2 7 2007
Owner's Name
PERMITTING
St. Lucie County, FL
Owner's Address
F { 34q51
Conttactor
Contractor's Address
. I certify that: The required Lapping and Fasteners of the underlayment
(roof felt); hot mop, if required and flashing have been installed in
accordance with Chapter 15 of the Florida Building Code an~ Chapter 9
of the Florida Building Code, Resid~ntial with approved revisions and
meet the requirements of the product approval.
I understand that by execuQn.g this Affidavit I hereby relieve St Lucie
County of any liability with respect to the installation of these· materials. .
OWNER/CONTRACTOR' S SIGNATURE
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STATE OF FLORIDA
COUNTY OF
STATE OF FLORIQA
COUNTY OF X ~ (kY) \lA y ~r-
The foregoing instrum.ent was acknow]edged-·
before me this _ day of , 20_, by
, who is personally
}mown to me or who has produced
as identification..
The foregoing jns~ent WÃ- þac~owJedged
before me this ~ day of f \ ,20 0] by
M p...ç ~o e c cR W Q~w, who is p-eTSonally
. known 0 me or who has produced
as identification.
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Type or ,Print Name ofNotlry
s¡ 8'1:\cure of Notary
TyPf: or Print N"me of Notary
Comroissjon. No. (Sea)) Commission No. b \):s ~ '1 q \..1 (s...._~~"-:. Caryn.H: Eichelberger
. ~~.~.~ ':, CoDlDUSSlon #DD334913
~¡,. ~.;;E Expires: Jul 06, 2008
No Faxed Copies, Only Original Notarized Copy will be acceptelii,~~~dJ.'" Atlanti~:OO~.,Inc.
Cml rcvi~ed 1117/2007
~4¡23/2007 02:08 7724521735
ST LUCIE CO
PAGE 02
DA TE:
PERMIT NUMBER . 0 L\ \ d - '~t (
RECEIVED
.
APR 2 7 2007
PERMITTING
St. Lucie County, FL
".. ....
ATTENTION: RAY W AZNY, BUILDING OFFICIAL
I rn(Ä~ Jo E rd we }~n
UILDER),
AM REQUESTING TIIA T mE ABOVE PERMIT NlJ!\.mER BE RE~WED. I
UNDERSTAND 1HA T 1 MUST SCHEDULE AND PASS ALL NEEDED
INSPECTIONS FOR TInS PERMIT TO BE ffNALED.
OWNER~ S
ADDRESS
~
AZUL
I
.c+ R~rl~ ç I 34 q5 I
1 '7 ~. 41, l./ · 0 L/.¡ ~
OWNER"S PHONE NIDvmER