HomeMy WebLinkAboutRoof inspection affidavitPlanning & Development Services
Building 8r Code Regulation Division
2300 Virginia Avenue
Fork Pierce, FL 34982
772-462-2166 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit # S�L C' ((J 0 Q — O ` 'i�
1, 'A AP (�� licensed as a(n)Contractor*/Engineer/Architect
(Please print name Sr circle Iicens type) TFS468 Building Inspector
'General, Building, Residential or Roofing Contractor or any individual certified under468 F.S. to make such an inspection.
3 /
On or about $ / ,? I did personally inspectthe roof deck nailing
(Date) I
work at: lfo
lob 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).
Signature and Seal
CCC 0-5--( 7,3 /
License #
STATE OF FLORIDA ,�//s1 .[
COUNTYOF /r(rf/=j 1 A �%
Swomtoand s b cribedb foremethis� day of 20 /U
by `S ��( f�l1d Who is personally known to me or who has produced
as identification.
G
Notary Public, State of Florid
Signature of Notary:
Commission Number: (Seal)
En 01/19/2011
Stephen P. Frederick
*6141"bloExpires
NOTARYPUBLIC
STATE OF FLORIDA
comm# GG048393
112712021