HomeMy WebLinkAbout9000 Island Bay CirCITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: 1 1p - (P 19
I, C V_C, _e_ hereby acknowledge that I personally inspected
P(Roof deck nailing and/or/Secondary water barrier work
at / j cr-Ql pw 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.)
I certify that my statements
understand that making any 1
perforinance of his or her off
Se4ioxi 837.06,F,S,
Siure of Co tractor
Printed Name of Contractor
herein are true and accurate to the best of my belief and that I fully
ipf statements in writing with the intent to mislead a public servant in the
duty shall constitute a misdemeanor of the second degree pursuant to
D to
F 1'J 133 40 -
License #
License Type: General Building Residential NaaaFh1g Contractor
or any individual certified in accordance with F.S. 468 to make such an inspection. -
STATE OF FLORIDA COUNTY OF n
Sworn to (or affirmed) and subscribed before me s 16 day of K-tcrcy , 20 / Ca , by
e v-- Qnal.eZ , who is ersonally Known tome or has Produced (type of
ident' ca 'on) as identification.
SEAL)
Sig>; a of NUfrkrAic
State of Florida
V •6 \ " ---\ a kj ve
Print/Type/Stamp Name
of Notary Public
Itwdm ummo pw a
NOTMY PUBW
8TATE OF FWRIDA
CMW FF244ZT
8r24/2019
Kraft mmmoA..
NarmY a18UC
c STATE OF FI..ORID6
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