HomeMy WebLinkAbout04121530
OS/22/2007 00:32 77246217~5
ST LUCIE CO
PAGE 02
:~,';:: ',~;~": ' ':.:: '. ~:\ ,', ~ I':' I .. I I I I .. I'" . .:'. \ , : ".. . . ... ;
Residential Roof Dry-In Affidavit
St Lucie County, Public Works Department
Code Compliance Division
Building PeriDit #
~o
ir -~.' , "\~~ :( . .
~. . \.!Ii¥'
~..II
~
'V
Owner's Name' ,
Owner's Address ~ -+ II A- J A-
Contractor a~ ~-rJ(~~ \ }rLLc.-~
Contractor's Address _Pi) ßð I.. ~fsd-'ì W~ J=C 3ð-cfò;}--
I certify that: The required Lapping and Fasteners of the underIayment
(roof felt); hot mop, if required 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 req,uirements of the pro.duct approval.
I understand that by execuQu.g this Affidavit I hereby relieve St Lucie
, County of any liability with respect to the installation of these materials.
SIGNATURE
HO:MEOWNER~S SIGNATURE
STATEOFFLO
COUNTY OF
STATE OF FLORIDA
COUNTY OF
The foregoing instryment was acknowledged
~f9re me this2Z"âay of ~ 20ß-by
~9r1~ ,~personaIJy
JQ1own_~or who has produced
as identificatioTJ.
V~þ'~ :I ¡f1/7-Á~
s¡;::;;~'-· BETTYL. LOWMAN
NOTARY PUBLIC - STATE OF FLORIDA
COMr~lg8IQ~1 -H nn~RA731
Type or Print N:ame ofNOIafy EXPIRES 4/28/2009
BONDED THRU 1-888-NOTARY1
Commission No. (Sea])
The foregojng instJUment was acknow.ledged
before me this _ day of , 20_, by
, who is personal]y
known to me or who has produced
as identification.
Signature of NotaÌy
Type or Print N~,"e of Notary
Com.mission No.
(Seal)
No Faxed Copies, Only Original Notarized Copy will be accepted.
Cm) rcviSf;d 1/]712007