HomeMy WebLinkAbout911 South Magnolia AveMAR 2 8 2016
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof BY --
Hurricane Mitigation Inspection Affidavit
Permit #:
hereby acknowledge that I personally inspected
Roof deck nailing/and/or Secondary water barrier work
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at and have determined that the work
Job Site Address) c--'
was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.)
I certify that my statements herein are true and accurate to the best of my belief and that I fully
understand that making any false statements in writing with the intent to mislead a public servant in the
performance of his or her official duty shall constitute a misdemeanor of the second degree pursuant to
Sectio 837.06 F.S.
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jattur:
eof Co>VZtracto Date
Printed Name of Contractor License #
License Type: General Building Residential Roofing Contractor
or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OF SOyn i nA U
torno (or af medj and subscribed'before me this _ day of / (S(1 , 20 1 !o , by
who is Personally Known to me or has Produced (type of
as identification.
Signature of Notary Public AStateo;lo` ,
Print/Type/St amp Name
of Notary Public
NAYDA MDNTANEZ
Notary Public - Slate of Florida
My Comm. Expires Feb 9, 2018
f° «o ,• Commission # FF 091054
Bonded Through National Notary Assn.
3