HomeMy WebLinkAboutRoof Inspection Affidavit Planning&Development Services
I Building&Code Regulation Division
COUNTY I 2300 Virginia Avenue
Fort Pierce, FL 34992
772-462-2165 or 772-462-2172
Fax: 772-462-6443 E C E VV ED
ROOF INSPECTION AFFIDAVIT FEB ® 8. X011
Re: Permit#
licensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle license type) *FS468 Building Inspector
*General,Building Residential or hoofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about I did personally inspect the roof deck nailing
(Date)
work at: -'( - - � �-`� I Z.� l i C' L �
(Job site address)
Based upon that examination 1 have determined the installation was done according to the current
edition of the Florida Existing Building Code Section 611 or the product approval submitted (whichever is
mast trigent},
Signature and Seal License#
STATE OF FLORIDA
CouN'iY OF giv
Sworn to and subscribed before me this 3 day of I' 20_1
by Who is personally known to me or who has produced
as identification.
Notary Public,State of Florida
Signature of Notary:
Commission Number: Seal
En 01/19/2011 Kerry James Ellis
Notary Public
2 State of Florida
My Commission
Expires 8/13/2018
Commission No. FF 150837