HomeMy WebLinkAboutRoof Inspection Affidavit Planning & Development Slur;-ices
Building& Code Regulation Division
2300 Virginia Avenue
o m Fort Pierce, FL 34982
- � � 772-462-2165 or 772-462-2172
Fax: 772-462-6443
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ROOF INSPECTION AFFIDAVIT Y�-
Re: Permit#_�
I,J'f4rt4 AnL)qsM , licensed as a( Contractor* ngineer/Architect
(Please print name &circle license type) *FS468 ul Ing Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about 61I131 19 , 1 did personally inspect the roof deck nailing
(Date)
work at: � � r 2°S it (I Pvrn,
Job site address)
Based upon that examination I 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
most strigent).
SCC 13 � L �► �
rigWatujle and SealLicense#
P` ��'1c
STATE OF FLORIDA
COUNTY OF (►�
Sworn to and subscribed before me this day of
by,)-EEC* A8M4gC SYN Who is personally known to me or who has produced
as identification.
Notary Public,State of Florida
Signature of Notary:
Commission Number: I Ce n J (Seal)
En 01/19/2011 �! p �! V
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MY COMMISSION#FF 160517
tember 16,2018
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