HomeMy WebLinkAboutRoof AffidavitRe: Permit #'%G -(
Jamie Cisco
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
(Please print name & circle license type)
licensed as a(n)Contractor*/Engineer/Architect
*FS468 Building Inspector
* General, Building, Residential or Roofing Contractor or any individual certified under 468 F.S. to make such an inspection.
On or about AX, I did personally inspect the roof deck nailing
(Date)
I
work at: I �e`1 r65
(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).
Signature and Seal
STATE OF FLORIDA
COUNTY OF Martin
CCC 1327796
License #
Sworn to and subscribed before me this day of F -(--h 2019
i`
by Jamie Cisco Who is personally known to me or who has produced
as identification.
Notary Public, State of Florida ) <�7� \
Signature of Notary:--' �}�
Commission Number: (Seal)
En 01/19/2011
2pY Notary Public State of Florida
Marilyn Kluegel
OF LYMy Commission FF 230179'
Expires 06/28/2099 �`
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Re: Permit #'%G -(
Jamie Cisco
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
(Please print name & circle license type)
licensed as a(n)Contractor*/Engineer/Architect
*FS468 Building Inspector
* General, Building, Residential or Roofing Contractor or any individual certified under 468 F.S. to make such an inspection.
On or about AX, I did personally inspect the roof deck nailing
(Date)
I
work at: I �e`1 r65
(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).
Signature and Seal
STATE OF FLORIDA
COUNTY OF Martin
CCC 1327796
License #
Sworn to and subscribed before me this day of F -(--h 2019
i`
by Jamie Cisco Who is personally known to me or who has produced
as identification.
Notary Public, State of Florida ) <�7� \
Signature of Notary:--' �}�
Commission Number: (Seal)
En 01/19/2011
2pY Notary Public State of Florida
Marilyn Kluegel
OF LYMy Commission FF 230179'
Expires 06/28/2099 �`