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x Code Compliance Division
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� COUN 2300 Virginia Avenue
• R I . A Fort Pierce, FL 34982 .
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772-462-2172 Fax: 772-462-A,43
INSPECTION AFFIDAVIT MAY 3 ? 291?
PER"if
i
St. Lucie Count;
Re: Permit# I !In� u ('o r1'3
licensed as a( Contract ngineer/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 on ins on.
On or about 51`7 , I did personally inspect th roof deck nailin an r
-- (cl apply)
Seco water barri ark at: j_ y Jaz Q T, T LQCA-,
(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.)
Signature and Seal License#
STATE OF FLORI A _
COUNTY OF
Sworn to and s b' ibed e o e
f r me this � da o 2
/� � v i9y o]�,
by � �� 1n�11� Who is perso y known to me or who has produced
as ide ification.
Notary P ori
Signature
Commission Number: • (Seal)
En 09/17/09KAREN S. NIELSEN�
Commission# FF 115637
A
- .�- My Commission Expires
June 12, 2018