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DA TE:
RECEIVED
APR 2 6 2007
PERMIITING
St. Lucie County, FL
PERMIT NUMBER ~ (jC)() l-jJ.ó7·~
ATTENTION: RAY W AZNY, BUILDING OFFICIAL
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I Ul/¡/l/'L ¿~ -c- þiltJí/? :ú-
, (OWNER/BUILDER),
AM REQUESTING THAT THE ABOVE PERMIT NUMBER BE RENEWED. I
UNDERSTAND THAT I MUST SCHEDULE AND PASS ALL NEEDED
INSPECTIONS FOR THIS PERMIT TO BE FINALED.
OWNER'S · C' . ¿:- J / //2 Lf'1':.. / ;0.. · C/ ? r/. ,9-;?"
ADDRESS I J C:;) /U <--f' "7 r ZJ¡rt I I L ~t1' -c / (,. ?'!' rc¡ ,/
OWNER'S PHONE NUMBER 7!7 ;2 -- éí'?;- t/'- 0/' \7 ¡? _.
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OWNER'S SIGNATURE
Rlr.Jidential Roof Dry~ . ~n Affidavit
5t Lucie County, Public Works Department
Code Compliance Division
Building Permit # o/){) ( - ;JÕ}7
Owner's Name_VV/(~(' ) Y 1: jJoíllOe/t,--S ~
Owner's Address / ~·~o '5'- (if q'¿ 7-f¡-~/'f J1't;.Æ ~ -c-
. ¡J('tlFtll'1l ~
Contractor (?/j//l( C ¡L ~ W¿J/tfL ¥
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 executing this Affidavit I hereby relieve 8t Lucie
County of any liability with respect to the installation of t se materials.
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H011EOWNER'S SIGNATURE
STATEOFFLO~ '4 ·
COUNTY OF · /Æ/l
STATEOFFLO~ \ /J _
COUNTY OF · ~
-
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The foregoing instrument was açknowledged The foregoing instrument was asknowledged
be~o~ me this ~day offiJ2lUL, 20flZ by before me this¿ day ofi , 20~7by
tJJ{l-i-{ ~ '~ÐtJ?:J c 12 ~personally Þ I\{ l:> - ho is personally
known to me or who has produced knO~to me ~ who ha..$ produced
C~. P!<' L i(~~ as identification. (/. . ~4.4 V\.r ~/. as identification.
? · 'fq ~. J O· yÇ;;G·O Of), - _
(Sea])
Sig ture of Notary
~~7 53, J/tt,/11P.þ-£ey
TypeorPrintNameo - oUUy ~
Commission No. (Seal)
Commission No.
No Faxed Copies, Only Original Notarized Co ...,~~ U . R
,\\\"'~~"'~.. AUDR. EY B. HUMPHREY II L'»~ is, MY COMMISSION # DO 633047
Cm] revi sed 1/1 7 /2007 !.r.;Q~~ MY COMMISSION # DD 63304 ì II ~. .: EXPIRES: March 6, 2011
~\ lV EXÞIRES: March 6,2011! ~''':ól, · BondedThru, ~otary Public UndfJrwrlt6tS
I ·~f,iFf.I· ..' Bonded Thru Notary Public Underwritw:; -1 ¡