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Building & Code Regulation Division
2300 Virginia Avenue i
Fort Pierce, FL 34982
772-462-2165 or 7724624172
Fax: 772-462-6443
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ROOF INSPECTION AFFIDAVIT
i
Re: Permit #
Ick1, i Ul ,. . licensed as a(n)Contractori*/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 m I'ke such an Inspection.
On or about (' /7, i did personally inspect the roof deck nailing
(Date)
t i
work at: 2- 6
(Job site address)
Based upon that examination I have determined the installation was donelaccording to the current
edition of the Florida Existing Building Code Section 611 or the product approval submitted (whichever is.
most strigent).. j
C�oa I
Mignatureand Seal License # ,I
Ed SE41 g ,ZQ'�
STATE OF FLORID
COUNTY OF ,4
sweR to and subscribed before me this i— day of _� `20%�
by !n Who is personally known to me or who has prod'I ced
as identification.
Notary Public, State
Signature of Notary. J
Commission Number: (Seal)
En 01/19/2011
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CASH=,r11VA liy�xri, :
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Notary Public
-State 01 ri.,
COMM Expires Dec 20
COMMIssion # FF
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