HomeMy WebLinkAbout801 Bay AveBuilding and Fire Inspection Division
DCA03 - DEC - 133
SEMINOLE COUNTY
FLORIDA'S NATURAL CHOICE
AFFIDAVIT MAY BE USED WITH IN
PROGRESS INSPECTION FOR RE -
ROOFS FOR SINGLE FAMILY
RESIDENCE'S CONSTRUCTED PRIOR
TO 3-01-2002
PERMIT #J - '��7 DATE 1` o`� b`7
JOB ADDRESS
LOT / SUBDIVISION
COMPANY '� r �e US(\, Inc .
licensed as a(n) Contractor*,
Please print contractors
Engineer, or Architect with license #
did personally inspect the roof deck nailing and/or secondary water barrier on or about,
I 'a 0
Date & Time
Based upon that examination I have determined the installation was done according
to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.)
Contractor: Signature & Date Owner: Signature & Date
STATE OF FLORI
COUNTY OFn
Sworn tIIo'' 'andll subscri ed before me this day of _, 20
by ✓��. `X>mh �'� `— . Personally known or Produc=�tifi ation
Printed Name Type of Identification Produced Zc;e�—�
n
Nota Public, State of F ori a
HANNE�ORE C. ELVESTER
P�!raJ) Notary Public - State of Florida
-My Commission Expires Aug 16, 2009 Notary Signatu e
Commission # DD 462522
Bonded By Natonal Notary Assn.
Commission No.:
* General, Building, Residential, or Roofing contractor or any individual certified under 468 F.S. to make such an inspection.
1101 EAST FIRST STREET SANFORD FL 32771-1468 TELEPHONE (407) 665-7050 FAX (407) 665-7461