HomeMy WebLinkAboutUntitled 05/18/2017 12:30 GarY Harzo, Inc. 7724858829 1,10.784 '4001
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
i
Re: Permit# 110
r11 �
I, ' licensed as a(h)Contractg!�/Engineer/Architect
(Please lfrint name&circle license type) *FS4�84u`fFding Inspector
General,Building,Residential or noofing Contractor or any Individual certifted under 468 F•5,to make such an Inspection.
On or about r U _� I did personally inspect the roof deck nalling
(Oate)
work at:�� Y
(Job site address)
Based upon that examination I have determined the installation was done according to the Hurricane
Mitigation Retrofit Manual (Based on 553.844 F.S.)
Si n ture an eal License#
STATE OF FLC qA f . .
COUNTY OF \_ l AJt L c l�
Swofmto and subscribed before me this day of 20
by W4(,� Who is personally known t6 me or who has produced
as Identification.
Notary Public,State of Florida
Signature of Notary:
Commission Number: (Seal)
En 01/19/2011
DAVID VANDERFL,IER
; � My COMMISSION#FF0911680
,,� EXPIRES March 9,2ols
(ao �3g6-0tss Flodd&NuuuyServta#.aoro