HomeMy WebLinkAboutRoof Inspection Affidavit Planning& Development Services
Building&Code Regulation Division
® 2300 Virginia avenue
® Fort Pierce, FL 34982 "k;;T
772-462-2165 or 772-462-217 '1
Fax: 772-462-6443 OCT 0 4
2011
ROOF INSPECTION AFFIDAVIT@fx
Re: Permit# 15111
1, ICIL2A ,(.fi2/°licensed as a( Contractor* Engineer/Architect
(Pleas print name&circle license type) *FS468 Building Inspector
`General,Building Residential or Roofing Contractor or any individual certi ed under468 F.S.to make such an inspection.
On or about l O—O l- Zo 1; . I did personally inspect the roof deck nailing
(pate) / �� r
work at: P�DS 1`�/ q2 `� �YT p/P1"Cc_
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition o the Florida ExistingB�Ilal ov q Section 708 or the product approval submitted (whichever
is most trigent). r
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Signature and Sea) �aaQ License#
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Sao
STATE OF FLORID
COUNTY DF C k
Sworn to and subscribed before m this day of 20___,
by '�• {;�T, Who is personak Own to me or who has produced
as identification
Notary Public,State of Florida
Signature of Notary:
Commission Number: (Seal)
En
CHRIS W GEIST
My COMMISSION#GG050970
I '''uric,.•' EXPIRES November 29,2020
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