1101 EAST FIRST STREET SANFORD FL 32771-1468 PHONE (407) 665-7050 FAX (407) 665-7486
bpcustomerservice@semiolecountyfl.gov
COMMERCIAL RE-ROOF IN-PROGRESS AFFIDAVIT
MUST BE ONSITE FOR FINAL ROOF INSPECTION
PERMIT # :
JOB ADDRESS:
LOT / SUBDIVISION:
COMPANY:
I, , licensed as a Contractor, license
Please print name
number , did personally inspect the underlayment and roof
License number
Insulation (if installed) on or about, . I certify all of the
Date and Time
materials installed, match the product(s) listed on the County approved Re-Roof Supplement
Form. Based upon that examination, I have determined the installation and all materials used
were done in accordance with the current Florida Building Code – Existing Building Volume.
Contractor Signature and Date
STATE OF FLORIDA )
COUNTY OF _______________ )
Sworn to and subscribed before me by means of [ ] physical presence or [ ] online
notarization, this _____ day of _________________, 20___, by ______________________
_____________________________ (name of person acknowledging), who is [ ] personally
known to me; or [ ] has produced __________________________ as identification.
________________________________
Signature of Notary Public (SEAL)
