PERMIT DOCUMENTS ' L•_cr Ge
4.1ItCity of Boynton Beach
Building Division
LICENSED ROOFING CONTRACTOR
AFFIDAVIT
ROOF METAL & ROOF SHEATHING INSTALLATION
(EXISTING DETACHED ONE & TWO FAMILY DWELLINGS ONLY)
The City of Boynton Beach offers progressive inspections— call 742-6355
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. 16-968
From: COMNET CONSTRUCTION, LLC (Contractor)
4800 N FEDERAL HWY 6205, BOCA RATON, FL 33431 (Contractor's Address)
DIANE HENSHAW (Owner/s Name)
501 SW 20TH ST, BOYNTON BEACH (Property Address)
CERTIFICATION SELECTION: (Please check all that apply)
IiCertification of roof metal installation, flashing, underlayment.
(]Certification of re-nailing roof sheathing, and removal and replacement of damaged or rotted wood.
Other 49ev (44 kVA-Nar
I, JOE DAVIDOW , am certified as a roofing contractor (License No.
CGC 007463 ) and do hereby certify that all roof work (as indicated above) has been performed
at the above address in accordance with Chapter 15 of the Florida Building Code, Existing Building, as
amended, and Manufactur: pecifications. I understand that the City of Boynton Beach offers progressive
re-ro spec ns. I a . ed the owner of the property of this affidavit.
,GAt/I
a ure of Quali Date
STATE OF FLORIDA, COUNTY OF PALM BEACH
.re.." . ' ment was acknowledged before me thisjwilt )0 Z0/date)by JOE DAVIDOW who
is personally known to - or who has produced (type of identification) as identification
- • • ••• • •t)take an oath. f , (SEAL)
Signature of person taking acknowledgement /'/ q �r� — — — — — -
i • L
Name of officer taking ackn.• - :: - •• -• —• •e - - - - 4 ir.-:. KATHY M BATTAGLIA )
r\ Notary Public•$tete of Aortas 0
Title or rank Serial number '4'. Commission•FF 213025
My Comm.Expires Mar 24.2019
4.. n';`' Baxbe thonpl Natronal Notary Assn. 1
100 East Boynton Beach Blvd, PO Box 310, Boynton Beach FL 33425-0310 Phone:(561)742-6350 Fax:(561)742-6357
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