HomeMy WebLinkAboutRoof Inspection Affidavit Public Works Department
. 4:- v=: • - ; Code Compliance Division
� COUN 2300 Virginia Avenue
• R I . Fort Pierce, FL 34982
772-462-2172 Fax: 772-46Z-6443
INSPECTION AFFIDAVIT
Re: Permit# l] f-2>
I, RicVla rd . W Taick►.i..l licensed as a(n) ontractor /Engineer/Architect
(Please print name&circle license type) *FS468 Bui ing Inspector
*6eneral,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
on or about I did personally inspect the roof deck nailing and/or
(Date (circle those that apply)
secondary waterbarrierorkat: 10"1 St Plac►t'aCt- `PBy�. �t�IA-- Luc FL ?�4C
w 1
(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 FLORID
COUNTY OF
Swo to and subscribed before me this_t day of 20-11-1
by 6�iC n '1 rG{,Be h U.•Who is perso mown t me or who has produced
S
as identification.
Notary Public,State of Florida �Zl/
Signature of Notary:
Commission Number: (Seal)
En 09/17/09
AUDREYB.HUMPHREY
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'A'+ MY COMiciISSION#FF 1"14772
.'. .co EXPIRES:March 6,2019
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. Bond9d Thru Moiary Puo!ic Undemvriters