HomeMy WebLinkAboutRoof Inspection Affidavit Public Works Department
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Code Compliance Division
2300 Virginia Avenue
• . - Fort Pierce, FL 34982
772-462-2172 Fax: 772-462-6443
INSPECTION AFFIDAVIT RECEIVED
JAN 1 8 �0f8
ST. Luc(@ County, Par
Re: Permit#SL C 171Z-G('�� mltt►ng
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I, Q licensed as a(n)Contractor*/Engineer/Architect
(Please pri t 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.
1
On or about I f' Z c�(� I did personally inspect the roof deck nailing and/or
(Date) V(circle
those that apply)
secondary water barrier work at: Z Ga �c1 fL,� �c� �`t E.
(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.)
CLQ \� -2-
Signature Zand Seal License#
STATE OF FLORIDA'
COUNTY OF
Swo n t and sub cri d befor me this day of �� 201
by Y is personally_knQwnro mP nr who has produced
as identi icon.
i
Notary Public,State of FI ida
Signature of Notary: lk
Commission Number:
(Seal)
KEA
Notary public- MEY
En 09/17/09
. m St e
,MY COMMoission# t of Florida
Bon m .Expires G 0?4g18
ded through Nation/Notarr y ec 16,2020
Y Assn