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I Residential Roof D y-In A
5t Lucie County, Public Works Department
Code Compliance Division
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Public Works
Building Perinit #
Owner's Name
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Owner's Address
Contractor
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Contractor's Address
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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 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.
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HONIEO\V~TER'S SIGNATlJRE
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STATE OF FLORID~ " r::-:¿
COUNTY OF :J.~ 5'0 ~ r (
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The foregoing instrument was acknowledged
before me this 1$ Itday of ~, 20~ by
.s71J¿)~r- t:" &0 hI'" ,-~personal1y
known to me or who has produced
as identification.
STATE OF FLORIDA
COUNTY OF Sri- ¿t'f ~. i~
The foregoing instrument was acknowledged
before me this ~ay of ~ ' 2CÞ-=Z, by
P" L~J. s ¿ 1n:~ n d3 wno is personally
known to me or who has produced
as identification.
G. Browrl
TypeorPrintNameo€rs~tar ð :*~ om!11lssJon 248474
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.. ""I~f,~~~\" Bond~r~
COffil11lSS10n No. Âtlrmti", R0h~¿, Inc
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,'~~~~~¿.2,/~lgnature ~f N?tary
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:~~ . ::;: Com!1'is~iOQ #D02484i
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/" ~flF(;\\\ Bonded Thru' II) ,
Commission No. Atlnot/(' Rf'l1ding rc ~Seal)
Signature of Notary
No Faxed Copies, Only Original Notarized Copy will be accepted.
Cm] revised 1/17/2007
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