HomeMy WebLinkAboutRoof AffidavitPlanning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit # LC 2W-- 0,S 7
1, Estela Renteria licensed as a(n)Contra cto r*/Engi nee r/Architect
(Please print name & circle license type) rt d0,1, [ *FS468 Building Inspector
'L,C /32 4 SSL
*General, Building, Residential or Roofing Contractor or any individual certified under 468 F.S. to make such an inspection.
On or about I did personally inspect the roof deck nailing
(Date)
work at: R96 G Q&&411r15 `D " Z 0I 3 `1 q J5. z-
9
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of the Florida Existing Building Code Section 708 or the product approval submitted (whichever
jqSign2atu;re
ian�dSeal
STATE OF FLORIDA
COUNTY OF Palm Beach
CCC 1326556
License #
sworn to and subscribed before me this Of1�day ofF-"- Lrai'/j _ 20_LL
by Estela Renteria Who Is personally known to me or who has produced
PL driver's lie. 'dent' ation.
Notary Public, State of F
Signature of Notary: Z JEAµE{(RAMOS
Y ffliwi
Commission Numb r Notary Public State of Florida
<Commission # GG 241703
EnM Comm. Expires Jul 25, 2022
Y
Bonded through National Notary Assn.
pa's
MICHELLE R. MILLER, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY
FILE # 4813741 OR BOOK 4549 PAGE 1436, Recorded 02/04/2021 09:26:33 AM
NOTICE OF COMMENCEMENT g J r S- 701 - U d 0 3- Uu) 6
Permit No. Property Tax ID No. 316-701-0003-000-6
State of Florida, County of St. Lucle
The Undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
Legal Description of property and address if available THE WOODLAWOLOT3
896 WOODLAND DR PORT ST LUCIE FL 34952
General d
'. Owner/les
Address 1
improvements ROOF REPLACEMENT
Intel est in property: OWNER
Fee Simple Titleholder (If other than owner)
Address
Contractor CASA BLANCA CONSTRUCTION INC
9545922410
Phone #
Address 467 SOUTH FLAGLER AVENUE BAY64 POMPANO BEACH FL 33060
Fax #
Surety
Phone #
Address
Fax #
Amount of Bond
Lender
Phone #
Address
Fax #
Persons within the State of Florida designated by Owner upon whom notices
or other documents may be served as
by Section 713.13 (a) 7., Florida Statues:
provided
Name
Phone #
Address
Fax #
In addition to himself, owner designates
Phone #
Fax #
to receive a copy of the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes. Expiration date of notice of
commencement is one year from the date of recording unless a different date is specified. WARNING TO OWNER:
- _ ANY PAYMENTS :MADE BY TIM OWNER AFTER THE E"IRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER
PAYMENTS UNDER CH.713.13, F.6., AND CAN RESULT IN YOUR PAYING 2W10E FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
TI'^
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECON. TF YOU IN'I"END TO OB TATN
COMMENCMENT.
FINANCING, CONSULT WnH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF
I 1/a/A ,
U/�--�'-�'-S./ -s &4,),
Owner/I.essee, or Owner's or Lessee's Authorized Of lcer/Director/Partnernto-2-1 Slgoenrre
/vi l III /,l,-I-t RI h,
4-JSlgnatory's ..mjUtQcc
( V --
State of Florida, County of 1 V LI'C �U,747
Acknowledged before me this 2q . day of r,, 20 � kf by 0 J02t-•%
Who Is pee nqN know to me svho has produced as identification.
j05P
r
S ature of Notary
Y Type��or//Print Name of
Notary
Title: Nntary Public Comuilssion Number 1962_07 0(9 f?'. JOSERENTERIA
_ MY COMMISSION N GG 207306
EI(PIRES; April 15, 2022
71xutaU Pubr. UDdenNtRers 11
I OFRk R1r FRIIFV III1r IRIN Ixxa MPNl IS4TROT. NOt ORRECTfl1Y\OPA.N OVER I,I I.REl1OR11OR Digitallyy siggned byy The Honorable Michelle R. Miller
DOtr MENTAI rRORI/EDDlI1EI'TORE RFCOREIED OR FILMINDAM:.{LL!' Rk:('ORIIk:DOR FII.ED IN Date: 2021.02.04 09.31:53 -05:00
T,iF IIFFR E irk IJIE CI I: IE COI NTF CI F RK OFTRF CIR(TIT MI RT.
TIIISIxxTMk'USI11 Nnt k'NT.U�(TIIINI ,RFuoIRrnRu .n. Reason: Electronically Certified Copy
sl, RrrF rkcClFc,LERK.caLw,k Rl,cevr. F T,k,.,Fk,c'L,�REODROR,,, rAnD.aT' IJIJEW IkwM T. Location: 201 South Indian River Dr, Fort Pierce, FL 34950