HomeMy WebLinkAboutRoof Inspection Affidavit 4 Planning & Development Services
I :-� Building&Code Regulation Division
2300 Virginia Avenue
o - Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# ! 211•
I, -yIcensed as a(n)Contractor*/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 make such an inspection.
On or about d x-617 , I did personally inspect the roof deck nailing
(Date)
work at:
(Job site address)
Based upo examination I have determined the installation was done according to the current
edition the F ori,a Existing Building Code Section 708 or the product approval submitted (whichever
ism tSt ' t
nature and Seal License#
7
STATE OF FLORIDA r
COUNTY OF
Swofn to and subscribed before me this 4 day of De C 201-�.`
bM N:gLOhI N Tro4e iiot Who is person mown me or who has produced
as identification.
Notary Public,State of Florida
Signature of Notary:
Commission Number: eal)
En
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DEC / 2017 '
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f�='r ':w= f6i1'COIb MISSION#FF 174772
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=`;A : EXPIRES:March 6,2019
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2rnded Th u Notary
Public Underwr ters
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