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Building&Code Regulation Division
2300 Virginia'Avenue
Fort Pierce,FL 34982 O
772-462-2165 or 772-462-2172
Fax:772-462-6443
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ROOF INSPECTION AFFIDAVIT
Re: Permit.#._IGO IL () .
1,2!�RJ(Ju W�h .Clcensed as X Contractor* Engineer/Architect
(Please print name&circle license type) *FS468 Building Inspector
*General,Building,Residential or Roo+frng Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about A6 t: ,i did personally inspect the roof deck nailing
(Date)
t_
work at: 6-111 x J .
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of the Wide ide Existing Building Code Section 611 or the,
product approval submitted{whichever is
most igent.
Y\,-- Cc'c'1 5-v�b:zq(0
S attire and Seal License#
STATE OF FLO A
COUNTY OF' =�-
Sw €wand sub cri.ed bef re me this 01-- day of ��20�
by M h tm" Who i rsonally know to me or who has produced
as identification.
Notary Public,State of Florid
Signature of Notary:
Commission Number:
,ME;' J01F'O'COti NOA
En tYl/19J2011 .Notuy Public-State at;L''OMMISsian M FF g" Mf Comm,Expaet
Bondedthraugn�:.•
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` Notary Public•State t,;Ffi, is
COMMISSian#FF 94`4t,3
Mi`Cotrim,Expires Jan 3.2020
Bonded through Natianai Notary Assn.