HomeMy WebLinkAbout2544 Clairmont Ave (2)REGARDING ROOF DRY -IN AND FLASH INGS
INSPECTIONS.
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AFFIDAVIT ,
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COMPANY: T(l' 9 LICENSE NO: C_. t
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PROJECT INFORMATION
SUBDIVISION:
PERMIT NO: 0 `7 51' 70
ADDRESS_ % lit-10A(C U
LOT:
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affiant,
hereby affirm that I am the duly licensed contractor of record for the above reference permit,
that all of the foregoing information is true and accurate, and that the dry -in, flashings at the above referenced address/lot has been
installed in accordance with all applicable codes and standards. CONTRACTOR . (
P Sela 1 P
nted nam ) Signature)
STATE
OF FLORIDA COUNTY
OF 01(2fQy)Se- This
instrument was acknowledged before me this A— day of /G, p t by the above referenced individual,
Sohn who acknowledged that he/she is a duly .licensed contractor with and
who acknowledged that he/she wasauthonzed to execute this document_ He/she is either
personally known to me or produced —L /0 L a),, 30 ~ as valid identification_ WITNESS
my hand and official seal this day of PAY
ROBIN K AUSTIN Ai
MY COMMISSION # CC 967870 EXPIRES:
September 17, 2004 Bonded
Thru Notary Public Underwriters Printed
Name: My
Commission Expires: r .
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