HomeMy WebLinkAboutRoof Inspection Affidavit Planning& Development Services
E" Building&Code Regulationi Division
2300 Virginia Avenue
o s Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax:772-462-6443 I
ROOF INSPECTION AFFIDAVIT i
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Re: Permit# L 0-2 �J�
1, ()f2ua ;2�- Qu licensed as a(n)Contractor*/Engineer/Architect
(Please p iii nt name&circle license type) *FS458 ullding Inspector
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*general,Building,Residential or Roofing Contractor or any individual certified under 468 F5.to make such an inspection.
On or about 23 1 did personally inspect the roof deck Mailing
(Date)
work at: �,l �C) 'tr 4
(Job site address)
Based upon that examination 1 have determined the installation wasldone according to the current
edition of the Florida Existing Building Code Section 708 or the product approval 'submitted (whichever
is most strigent).
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Signature nd License#j
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STATE OF FLOR! A
COUNTY OF t" tuu4 P i
Sworn to and subscribed before me this ` ''qday of 2otil
by ln` �.'�.a • VJ Who is personally own to me or who has produced
as identification.
Notary Public,State of Flo j l
Signature of Notary: Y l L ; ► MA DE LA LUZ VELASCO
Commission Number: (Sea!) :'.'MY COMMISSION*GG030399
EXPIRES November 28,2020
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