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4:� --- Planning & Development Services
j = Building& Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
-" Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#
I, A ndcIPW Grj-L licensed as 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 Lt._O�S-'1�� I did personally inspect the roof deck nailing
(Date) Q
work at: '110a &4hUrS a l i ,CU 3 �
(Job site address)
Based up that e aminatio I have determined the installation was done according to the current
edition the FI ida Exist' g B '(din ode Section 708 or the product approval submitted (whichever
is m strige
Signature and a License#
STATE OF FLORIDA � � � ^^'
COUNTY OF ,�} l�(J1`12,
Sworn to and subscr'bed before me this day of apri I 20
by Who is personally known to me or who has produced
as identification.
Notary Public,State of Florida
Signature of Notary:
Commission Number: (Seal)
En
2o,PpYFUg��o FAITH MASON
* * MYCOMMISSION#GG003939
w� a� EXPIRES:June 20,2020
lFaFF���\ BondedThruBudget Notary Services