HomeMy WebLinkAbout7000 Island Bay CirCITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: tet.
I, Com' r l hereby acknowledge that I personally inspected
11 oof decknailiand/or econdary water barrier work
at 003
J
f 0 % Gdf`Cl
rof
Job Site Address)
and have determined that the work
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
understan hat making any false stat ments in writing with the intent to mislead a public servant in the
perform*, erform ce his or her offi pal dut# shall constitute a misdemeanor of the second degree pursuant toSection37.0 I.S.
1(0
Signature f on actor Date
Printed Name o Contractor License #
License Type: General Building Residential Q Roofing Contractor
or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OF k7d_e N,/(k
I before me this day of 20 ) (,, by
who is sonally Known to me or has 6oduced (type of
as identification.
Print/Type/Stamp Name
of Notary Public
I
WALTER FLORES
Notary Public- State of FloridaCommission # EE 866557MYCommissionExpiresJan. 21, 2017RWWWMM