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` Building&Code Regulation Division
2300 Virginia Avenue
Fort Pierce,FL 34482
772-462-2165 or 772-462-2172
Fax:772-462-6443
ROOF INSPECTION AFFIDAVIT O l ey 17201,
Re: Permit# . 1704-0104
i Jamas Cady Thomaslicensed as•a £t5rrraetor*( n`g�tfle?rjArchitect
(Please print name&circle license type) *FS468 Building Inspector
'General,Building,Residential or Roofing Contractor or any individual certified under 468 FS,to make such on inspection.
f
On or abouts J I did personally inspect the roof deck nailing
(Dat )
work at: 7105 Donlon Rd Ft.Pierce,FI 34951
(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).
- - CCC1330830
--sign`ature and seal License#
STATE OF FLORIDA
COUNTY OF,9 r:v of 1
Swop to and subscribed before me this day of M E� 20
J'L �a s s Wkvis persc+faaily knownio me or who has produced
as identification.
Notary Public,State of oyjda ;:,< .; `i SHARON LISA 6LANKENSFIlP
Signature of Notary:�"��:��r1F�=�'zc�j :,� .' N#Fj=153633
Commission Number:Fc- -f-3,S' 8ust 24.10 t o
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En 61/19/2011