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7724625267
ST LUCIE CO
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PAGE £11
Residential Roof Dry-In Affidavit
St Lucie County, Public Works Department
Code Compliance Division.
Building Permit # D :2 a CtJ - D La q v¡ ~J-:
U eSú/A A i+mo[)-"
Owner's .A.ddress ~ J LJ S . ~
S·~ ~ W') \.-Dnû
Contractor's Address LDolo'f) ~ \f)')Q;\J(JL}
Owner's Name
Con,tractor
,,I
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 \vith approved revisions and
meet the requirements of the product approval.
I understand that by executing this Affidavit I hereby relieve 8t Lucie·
Connty of any liability with respect to the installation of these materials.
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HOMEOWNER'S SIGNATURE
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v ~~~/
T)'pc or Prinr Name QfNomry · ø.~:;'~
Commission No. (Seal) ,,'. Cornmjssion No. '~a!t-~~'
No Faxed Copies, Only Original Notarized Copy will be acce. ~
_fI
STATEOFFL~t .~
COUNTY OF . JU
Cml revised 1/17 tJ.007
STATEOFFLO~
COlTNTY OF . ,
APR. 27. 2007 7:25AM 77..~TEIN ALUMINUM
ST LUCIE CO
NO,7229 p, 5GE 81
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Building Permit # D:2 a ~ - D La q rr
U es tI,t e A A- tYì (J D T ~.
Owner's Addr.ess '~ ) LJ S ' ~
Contractor S·t~., W.) l ~Yl (; ·
Contractor's Address Lao lo A ~ rnctK.J(JLt Q,ce
Owner) s Name
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 reUeve St Lucie,
County of any liability with .~espect to the installation of these materials~
/¿~~~tt. ~ c. Jìa~..~
HO~OWNER'S SIGNATURE
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STATE OPFL
COUNTY OP
STATEOFFLO~' !~ 11. ·
COUNTY OF D.L... ~
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T~'pc Of Pot! r Nnme of N otlill')' ."', ~:. \.' (f;:\:'::.L;~~~ . ,:!J (: ,'0., { .~ ~;~~.~ yp IH N .IUO of N Olary r_~ ~
~ : ; .: l:/p .,:tG3: M.~ V , I~, ~~ 1:3 . '.. , ..J.I,"!"ì
Comm,ission No. <¡' "n~:> ~(Sðäl~n~,II!:;\!iCm~L.~~!Vc~::':~Comm,is8ion No. (Sea~ f1:.~""
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No Faxed Copies, Onl~ Original Notarized Copy will be acee.
Cml revised I J17/~007 ,~