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DATE: 4·;J7{)7
RECEIVED
APR 2 7 2007
PERMJTf.NG
St. Lucie COU:1ty Fl
PERMITNUMBER '¡f)52?/-c:2~D
ATTENTION: RAY WAZNY, BUILDING OFFICIAL
I ~ /n/\}2f.,,( v! (-~TYuz.;c' , (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
ADDRESS
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OWNER"S PHONE NUMBER
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k.;sidential Roof Dr)' - In Affidavit
St Lucie County, Public Works Department
Code Compliance Division
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Building Permit # [)5;OI--- ~~
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Owner's N ame ' ~ d f'\e.úf 4- h ~ Iv--" ~ (' / ¿, ¡ (;; 0 fý? c:--c_
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Owner's Address -3>~~/be,rIPlYV!- Dr,Vk'
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Contractor
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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 St Lucie
County of any liability with respect to the installation of these materials.
"l
Only Origil1al Notarized Copy wil .~'l4Cc,eø . HUMPHREY. " ¡.
¡ . ¡:~ ~~'ÝCOMM'SS'ON # DD 63304/ 't
.f~~.", AUDR ~\. .J;) EXPIRES: March. 6, 2011 , I.·i~
;..iì: ~ - ~ MY COM.MEY B. HU. MPHREY 1Jf.... W Böf1t1ed Thru Ncrtary PublIC Undílrwmers I
! \:~ ,aSION # DD 633047 III .. ' ' . : . .
, · · ~ EXPIReS; March 6 2011
'''~ Bondtd fhru Not.ry Public Underwriters
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O:~~~~~~~;~~;;~~URE
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~~~~Fo~ORID~)l~ ¿,L,{ i't::-
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The foregoing instrument q;:¡~OWledged
before me this .27 day of , 2011 by
Jd. ~ btJYlJ~ , who is personally
known to e or who has produced
r;1/J' c-VJe·L ¡(J../ as identification.
6 ~>O. 5t3. 7Y'· <?YV,O
(Ål1i';P-' ,ð.~<,,~
SIgnature 0 No
/Júl)~ 2? ~~I/
Type or Print N -e of Notary I
Commission No. (Seal)
No Faxed Co
Cm1 revised 1/1 7/2007
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H0M110~WS/SIØNA TT~D/)
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ST ATE OF FLORIDA../. ..,
COUNTY OF S,'"
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The foregoing instrument was ac.knowledged
before me this:!z day Of~~ ' 20Eby
Ktm~ GtJrnt:;:6, who IS personal1y
known to e or wl}o has produced
~ ¡.J1. :DR ·L--I ~ as identification.
Signature of otary .
~ i/Ze'l ~~ IIt<--mPµ~
,/ Type or Print Name of Notary /
Commission No. (Seal)