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- -:esidential Roof Dlj-In Affidavit
St Lucie County, Public Works Department
Code Compliance Division
Building Permit # 5Lc. 052>:<- O~/d..
Owner's Name c:ø f)~ 11· C£RYi¡J'ò
Owner's Address !:J7./0t/ rJ1~T ¿£{;vAl Í-A-tJ'E, [;rrr(?rE'(l['E, FL3L/ft/~
, I I·
Contractor
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
Co of any liabilit with respect to the installation of these aterials.
~
7
SATE 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.
(Sea])
No Faxed Copies,
CmJ revi sed 1 /1 7/2007
'~
,'" :,U{)
STATEOFFLO~. WÚ~ß
COUNTY OF '~,' -~.
ment w. cþ1owle~ed
~~i5 {,2~,by
1 I , w 0 is personaI1y
r~duced
V as IdentIfIcatIon.
Commission No.