PERMIT DOCUMENTS City of Boynton Beach
ArtT°� Building Division
INSTALLATION AFFIDAVIT
WINDOW & DOOR (replacement)
To: City of Boynton Beach, Florida
Department of Development- Building Division
Field Inspection Section
100 East Boynton Beach Blvd., PO Box 310
Boynton Beach, FL 33425-0310
Re: Permit No. 15-5202
From: Paradise Exteriors, LLC (Contractor)
1918 Corporate Drive, Boynton Beach, FL 33426 (Contractors Address)
Ronald&Vema Carr (Owner/s Name)
600 Snug Harbor Drive unit A14, Boynton Beach, FL 33435 (Property Address)
CERTIFICATION SELECTION: (Please check all that apply)
❑■Certification of Window Installation
nCertification of Door Installation
❑Other (glass block, etc)
I, Dan Beckner , am a licensed contractor (license No.
SCC131150472 ) and do hereby certify that all work (as indicated above) has been performed and
installed at the above address in accordance with the Florida Building Code, Existing Building, as amended,
and Manufacturer's Installation Instructions/NOA/ Product Approvals submitted.
4/12/2016
Signature of Qualifier Date
STATE OF FLORIDA, COUNTY OF PALM BEACH
The foregoing instrument was acknowledged before me this 4/12/2016 (date)by Dan Beckner ,who
is pe all known tom •or who has produced (type of identification) as identification
and who did (did not)take an oath. (SEAL)
•Signature of person taking acknowledgement ('101! Q 7-J7a'°""4'' SOPHIE MARIE ELLISON
Sophie Marie Ellisa k' MY COMMISSION 3,2900
Name of officer taking acknowledgement—typed, printed or stamped p __.`eP,! ExPIRES December 3,201a
Title or rank Serial number FF180900
1=1;96.0153 Flo;IduNotan,Scrylce.com
100 East Boynton Beach Blvd, PO Box 310,Boynton Beach FL 33425-0310 Phone: (561)742-6350 Fax:(661)742-6357
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