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ST LUCIE CO
PAGE 01
Residential Roof Dry-In Affidavit
St Lucie Coullty, Public Works Department
Code Compliance Division.
Owner' s .i~ddress
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Contractor ,-Cjt~!\ + C0') l i)n C
Contractor's Address lcoLo -f) S m OJ\lcl ~,-l
Building Pennit #
Owner's Name
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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 \vith 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 these materials.
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STATEOF9-A\ ~
COUNTY OF '
STATEOFFL~
COUNTY OF
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No Faxed Copies, Only Original Notarized Copy will be accepf;i{ .
T)'pc or Pnn r Name Qf Notary
Comm.ission No.
C.m] revised 1/17/7-007
7:25AM i7=STEIN ALUMINUM
ST LUCIE CO
NO, 722 p, 4,GE el
Residential Roof Dry-In Affidavit
St Lucie Coul'ty~ Public Works Deputm:ent
Code CompUance Division,
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Owner's Addr.ess \3 ~ 3 ~ SlQ 1~L9¿uí) ~.~ ~ ntb
· Contractor \3t ~n -t W·) ~ i)n C
Contractor)s Address LcolD:A S IT1OJ\ kL.J -f1.;(
Owner's Name
Building Permi.t 1#
I certify th.at: The required Lapping and Fasteners of the underlayment
(roof felt);~~ bot mop, if required and flashing have been in'stalled 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 apPJlova).
I understand that by executing this Affidavit I hereby relieve St Lucie.
County òf any UabUlty with respect to the iDstallation of these materials.
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STATE OP 8A\ ~
COUNTY OF
STATEOFFL_~'
COUNTY OF
tn1meMow]ovi;d
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t who is persopally
a:æ. 01' W 0 has produce
as identification.
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.tM ~~_~~~ _ Type: oJ'PrintName ofNolary
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Co.mmjssion No- ..~~ ..',.'... 'y' :/:C~rnm.ission No,
CSI·, , «
No Faxed Copies, Only Original Notarized Copy will be accep
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CmJ rev¡sed 1'17~007
APR, 27, 2007 7:24AM STEIN ALUMINUM
NO. 722
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