PERMIT DOCUMENTS �.o Soil
o`4. City of Boynton Beach
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. 16-5011
From: Lowes Home Centers Inc (Contractor)
1500 Corporate Drive Boynton_Beach FL 33426 (Contractor's Address)
JOHN MCSTAY (Owner/s Name)
3020 MURANO BAY DR BOYNTON BEACH FL 33426 (Property Address) ,
CERTIFICATION SELECTION: (Please check all that apply)
❑�Certification of Window Installation
QCertification of Door Installation
QOther (glass block, etc)
I, Peter Anthony Cafaro III , am a licensed contractor (license No.
CGC1508417 ) 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 In Ilation Instructions/NOA/ Product Approvals submitted.
_ 12-23-16
t o
Signa • ter Date
STA OF FLORIDA, COUNTY OF PALM BEACH
The foregoing instrument was acknowledged before me this 12-23-16 (date) by PETER ANTHONY CAFARO t mho
is personally known to me or who has produced (type of identification) as identification
and who did (did not)take an oath. (SEAL)
Signature of person taking acknowledgement — ;--41,13;:,.. TIMOTHY D COOPRIDER
Name of officer taking acknowledgement--typed, printed or stamped TIMOTHY G COOPRI ° `F• Notary Public•Slate of Florida
Title or rank Serial number Commission a FF 939999
;,0t,
11 My Comm.Expires Dec 6,2019
( n.;, Bonded through Nallonal Notary Assn.
100 East Boynton Beach Blvd,PO Box 310,Boynton Beach FL 33425-0310 Phone:(661)742-6360 Fax:(661)742-6357
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