HomeMy WebLinkAboutRoof Inspection Affidavit Public Works Department
F E3 yr:.> Code Compliance Division
COUNTY
2300 Virginia Avenue
LORI • Fort Pierce, FL 34982
- 772-462-2172 Fax: 772-462-6443
INSPECTION,AFFIDAVIT
Re: Permit# n Off-C 'Nd
I, C� ►�r.� C_4z�-,�36-izIA SjC , licensed as n)Contractor* Engineer/Architect
(Please print name&circle license type) *FS468 Buil Ing Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
on or about tf-21•—n , I did personally inspect th o f deck nailin and or
(Date) (circle those that apply)
secondary water barrier work at: S-00 Q[cl_c►7 t%rz-, I Pce✓1P<-�
(Job site address)
Based upon that examination I have determined the installation was done according to the
Hurricane Miti n Retrofit Manual (Based on 553.844 F.S.)
Ccc�o5s�y23.��oz?"
Signature and Seal License#
STATE OF FLORIDA
COUNTY OF Sit'• �-O��t
Swo to and subscribed before me this a"1 day of 2&
by 9 �a n G as�to��►u A'G. Who is personally kno n to me or who has produced
'fir'. 0 L �as identification.
c�,
Notary Public,St�of Florida
Signature of Notary:3 ;�"" ''••,, DEANNA MARIE GIVENS
Commission Number: ls�dS41 ;, vcoM{�'�1 ,,IIRRN#GG 022023
EXPIRE@'�Eber 16,2020
Bonded Thru Notary Public Underwriters
En 09/17/09