HomeMy WebLinkAbout05012246
- ~. L~V-L C,~~ I
C.~ C :,~ O~
() .1-1 0 J
Wi1'~ ~0 LJdq,
(~~~J /D7
l' C~· -.
Y.1.c:iA.- ò Á-^-
I
~~, 1i~l{~t~ ~) «d~
J ~U )~ A-R5f~~ . -i-o CLvLlX&d-
~ ~L,,ª-:J- 7 ( D 1. ~ . 1 Ô {)¿d~:l-
4~1 ,(yi\rt-.
)
Cl.1 M/M J:Jg
~ /& 2 ~ :5 2:),J-·7
~~ Lf I ~ 7 3 <ð 65 I 7 ·
~0N'
4PR --Iv
~y. }J 3 lJ5Jj
~ ~ '.:d- "~ 200?
Ii ~ '. / ~~ D 50) - :2 & ' /
/
'~.!
.)ø ~U ~~ --Iv ;:¡ ~~~d(L Á~ fS) d- / 07
, .' ~ 1r~~
fl- ty -RECEIVED
APR 2 3 2007
'- i
Public Works
St. Lucie County, Fj...
~~' '7-J¡~
»)13
r-\ \ C ()î,-~-I -
de)fi1 t
DA TE:
PERMIT NUMBER D S:::J \ -, '~~'-\ \0
ATTENTION: RAY W AZNY, BUILDING OFFICIAL
I
Lù ~~1 ~
, (OWNER/BUILDER),
AM REQUESTING THAT THE ABOVE P
IT NUMBER BE RENEWED. I
UNDERSTAND THAT I MUST SCHEDULE AND PASS ALL NEEDED
INSPECTIONS FOR THIS PERMIT TO BE FINALED.
OWNER'S ~
ADDRESS 5' . 4? lA I ,., /Íi I\) ft ß<:~ C1<T"
O\VNER'S PHONE NUMBER 17 :J-, - ~ 7 ð - 32 Z- c¡
(~,'^-~&- - ,+1 k -
Residential Roof Dry - In Affidavit
St Lucie County, Public Works Department
Code Compliance Division
Building Perinit # OC;Ot - 'ðà~\~J
Owner's Name ?J f A I 121...£ Y
I'
Owner's Address 5" C( k J t..J ./ A rØ A 7Z D D C. R T ·
Contractor
p~~~
-:::;.J.. 3 l+ 9 ~ 2-
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 and Chapter 9
of the Florida Building Code, Residential with approved revisions and
meet the requirements of the product approval.
I understand that by execut~ng 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 SIGNAT
~'. -..-------.. -~,. ...--....-...--.--...--.--.. .-.- ---- ._----..- -- -"' ._-- ---- --.-.- ---, _.' ---....---....---.-.-...-----. ----"-"--.-.-"-- ._-.._.-.. ... .__._-~----- -----------.----...--..--.---.....-.---.. ..._--
ST A TE 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.
Signature of Notary
Type or Print Name of Notary
Commission No.
(Seal)
STATE OF FLORIDA
COUNTY OF' ~ ¿lje/ IF"
The foregoing instrument was acknowledged
before me this /1 day of ~~/ L, 20[2 by
hJ I LL¡ 1)fr1 A R.Le , who is personally
known to me or who ha produced
A) ~i D I La' entification.
~;:? . -, -.
. ~ ~---~-<--;tL_.#/ --' \ '-v-?[~-y/,--
~ ' Signat of Notary ,
fr(/) e/ f1 AJ .- '(LU /1 / ..( )
Type or Print NameofNotlly
'1-
f-I
".8
I ¡If·,
I!
Commission No.
(Seal)
No Faxed Copies, Only Original Notarized Copy will be accepted.
Cml revised 1/17/2007