HomeMy WebLinkAbout10000 Island Bay CirCITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: I LP — 2'0
1, hereby acknowledge that I personally inspected
Roof deck nailing and/or Asec6ndary water barrier work
at i n^ xy I . 0!c± , CA r and have determined that the work
Job Site Address)
was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.)
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I certify that my statements herein, are ue and accurate to the best of my belief and that I fully
understand t at aking any false statem n1 in writing with the intent to mislead a public servant in the
performanc of hi or her offic' 1 duty s al constitute a misdemeanor of the second degree pursuant toSection837. 6 F.S.n A A
v
Signature of ntrac Date
Printed Name of Contractor License #
License Type: General Building Residentialt6800fing Contractor
El or any individual certified in accordance with F. to make such an inspection.
STATE OF FLORIDA COUNTY OF "li[ a '
Sw Q to (oi! a trpedt nd s sc ed before me tits day of , , 20 o , by
U , who is ersonally Known to me or has Produced (type of
identific
i io) as identification.
SEAL)
Sign re o Notarf Public
in Ty m Name
NO ub 'C WALTER FLORES
Notary Public- State of Florida ,
Commission # EE 866557 i7
My Commission Expires Jan 21, 2017 f
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