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W 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
Re: Permit#
I, �4A- <Z C(alv..y`,C1\,1 , licensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle license type) *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 ,Q I did personally inspect the roof deck nailing
Dat
i
work at:
(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
strigent).
Signature and Seal License#
STATE OF FLORID `
COUNTY OF1�
Sw�o{'�O and s cribed before me this 201 /
bk ) ( W s personally known o m Oho has produced
as Mentfi4czaV
Notary Public,State of Florida
Signature of Notary:
Commission Number:
'ANGELA M HUFF
{ r°t U«`� Notary Public-State of Florida f
En 01/19/2011 `! tt�:•_ Commission#. FF 234730
a My Comm.Expires May 27,2019
1 °, Bondcd through National Notary Assn.