HomeMy WebLinkAboutRoof Inspection Affidavit Planning&Development Services
Building&Code Regulation Division
2300 Virginia Avenue
! FL * Fort Pierce,FL 34982
772-462-2165 or.772.462-2172
Fax:772.462.6443
QO!FlNS_-_PECTIQN AFF12AVII
Re., Permit# ) �40
i, �� , licensed as��/Engineer/Architect
(Please print name&circle license typ *FS466 Building Inspector
*General,Building,Residential or Roof ing Contractor or any Individual certified under 468 F.S.to make Such an inspection_
On or about i did personally-inspect the�rpof decWling
(Date )
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
most strigent).
�.
Signatukdnd&I License#
STATE OF FLOR! A
COUNTY OF � G.0 t
5 tQe this � 200by an �Ied before mV h sonaily known me or who has produced
cation.
Notary Publlc,State of Florida `�'`�� ti�.2urg.
Signature of Notary;
Commission Number: (Seal)
`
En 01/19/2011