1101 EAST FIRST STREET SANFORD FL 32771-1468 PHONE (407) 665-7050 FAX (407) 665-7486
bpcustomerservice@semiolecountyfl.gov
WINDOW & DOOR REPLACEMENT - AFFIDAVIT
FOR WATER RESISTANT BARRIER FOR FRAMED
WALLS (MUST BE ONSITE FOR INSPECTION)
PERMIT # :
JOB ADDRESS:
LOT / SUBDIVISION:
COMPANY:
I, , Contractor for the permit listed above,
Please print name
license number , did personally inspect the installation of
the window(s) and/or door(s) and the required water resistant barrier(s). I certify the work is
in compliance 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)
