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Residential Roof Dry-In Affidavit
8t Lucie County, Public Works Department
Code Compliance Division
Owner's Name
.Jt?0 Addvess~ 32rf6 Mctvo.--
F1 ' P1evie, F(.
Owner's Address
Contractor
Contractor's Address
I certify that: The required Lapping and Fasteners of the underlayment
(roof felt) 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 th~ r~9.uirements of
the product approval. ' ,,;.,
I understand that by executing this Affidavit I hereby relieve St Lucie
County of any liability with respect to the installation of these materials.
: E
OWNER/CONTRACTOR'S SIGNATURE
HOMEOWNER'S SIGNATURE
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF Pö..t yY\. ~ h
The foregoing instrument was acknowledged
before me this _ day of , 20 _, by
, who is personally
known to me or who has produced
as identification.
The foregoing instrument was acknowledged
before me this ).~ dar of _f\-.øy \ .' , 20.Q] by
~ I ClkL.rtl (AJì~ \ ~personally
known to me or ho has produced
as identification.
Signature of Notary
~
. ll....
Ig ature 0f¡Notary
~ CL~ re-l Yv'--~
ype or Print Name of Notary
Type or Print Name of Notary
Commission No.
(Seal)
Commission No.
TRACY FElMET
Notary PubIc - S1Id8 of FIortda
CommIssion Expns Aug 21. 2009
~~ ~.... CommIssion' DO 464289
;,;t". n:. ~,~ .
"'fI"" BorwIed By NatiOnal NoIIry Assn.
No Faxed Copies, Only Original Notarized Copy will be
dmg revised 12/22/2006