PERMIT DOCUMENTS City of Boynton Beach Building Division
LICENSED ROOFING CONTRACTOR
AFFIDAVIT
ROOF METAL & ROOF SHEATHING INSTALLATION
(EXISTING DETACHED ONE &TWO FAMILY DWELLINGS ONLY)
TO: City of Boynton Beach
Department of Development— Building Division
Field Inspection Section
RE: Permit No. 17-2384
From: Christopher Bossier (Contractor)
613 Industrial St., Lake Worth, FL 33461 (Contractor's Address)
Norman Godfrey (Owner/s Name)
2109 SW Park Dr., Boynton Beach, FL 33426 (Property Address)
CERTIFICATION SELECTION: (Please check all that apply)
ErCertification of roof metal installation, flashing, underlayment
dcertification of re-nailing roof sheathing, and removal and replacement of damaged or rotted wood.
Other No\- in Fr eSS 'tn ?ro5rest
I, Christopher Bossier, am a certified roofing contractor (License No. CCC1326308) 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
Manufacturer's Specifications. I understand that the City of Boynton Beach offers progressive
re-roof inspections. I have notified the owner of the property of this affidavit.
ir,.tWi � ) 2b' � 17
Signature of Qualifier Date
STATE OF FLORIDA, COUNTY OF PALM BEACH 7�
The forgoing instrument was acknowledged before me this Z{J 04-9c;SD lvl7 (date) by
Christopher Bossier who is personally known to me or who has pro ed (type of
identification)and who did (did not)take an oath.
Signature of person taking acknowledgement
Name of officer taking acknowledgement—type•,printed or stamped
Title or rank Serial Number
4.x0:7:411.1"--.. MONICA I BARRERAS
MY COMMISSION#GG068588
',ter , EXPIRES February 01,2021