HomeMy WebLinkAboutLincoln - AffidavitPlanning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
,. Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit #
I, Larry Neese , licensed as a(n)Contractor*/Engineer/Architect
(Please print name & circle license type) *FS468 Building Inspector
*General, Building, Residential or Roofing Contractor or any individual certified under 468 F.S. to make such an inspection.
On or about I did personally inspect the roof deck nailing
(Date)
work at:
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of the Florida Existing Building Code Section 611 or the product approval submitted (whichever is
STATE OF FLORIDA
COUNTY OF �S°T.
CCC 1330608
License #
Sworn to and subscribed before me this day of 20
by 6 c.e ii Who is personally known to me or who has produced
as identification.
Notary Public, State of to ' m
Signature of Notary:L*-Vvw
HEATHER RING
Commission Number: �—p �rsrcol�llsslorrFFlaoszs
EXPIRES: July 10, 2020
En 01/19/2011
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement. _.
_ Sign re of 0 ner/ Lessee/Agent
CSA
STATE OF FLORIDA STATE OF 'FLORIDAL
COUNTY OF 3 i i; e COUNTY OF 531 t_.L.t_e,"
The forgoing instrument was acknowledged before me
this day of 20 _by
ALL C K)
(Name of person acknowledging)
(Signature of Notary Pub/lic ,S of Florida )
Personally Known ✓ OR Produced Identification
Type of Identification Produced ,__
Commission No.
Revised 07/15/2014
The forgoing instrument was acknowledged before me
this day of
20 by
41
(Name of person acknowledging)
_4A
(Signature of Notary Public- Stat orida )
Personally Known OR Produced Identification
Type of Identification Produced
HEA THSSION # FF140529 ERRING Commission No.
EXPIRES: July 10, 2020
FEATHER FJNG
3f NMSSION # FF140529
EXPIRES: July 10, 2020
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