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Building&Code Regulation Division
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2300 Virginia Avenue
Fort Pierce, FL 34982 L--
IVED
772-462-2165 or 772-462-2172
Fax:772-462-6443 2 `8
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ROOF INSPEMT®N AFFIDAVIT
Re: Permit# v Q f "G T Y-3
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licensed as a( Contractor's ngineer/Architect
(Please print"nse type) *FS 8 spector
*General,Building,Residential or Roofing Controctor or any individual certified under 468 F.S.to make such on inspection.
On or about
02 I did personally inspect the roof deck nailing
(Date)6A61
/'work at: GC�j Lrt • ; �co r!�'i �� � 9
(job site address)
Based upon that examination I have determined the installation was done according to the current
edition of the Florida Existing Building Code Section 611 or the product approval submitted(whichever is
most strigent).
gnature and Seal
Cleanse#
STATE OF FLORIDA 1
COUNTY OF
Sworn to and ubscribeobefore me this day of Zo ` �+
by . Who is personally known to me or who has produced
aseen i ica ion.
Notary Public,State of Florid
�. Signature of Notary: `
Commission Number: (Seal)
En ovigno11
Stephen P.Nderick
NOTARypUSUC
STATE OF FLORIDA
• C07VW GG048393
Expires 1/27/2021