HomeMy WebLinkAboutRoof Inspection Affidavit I -
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Building&: ode=Regulat�on Division
2300 Virginia Avenue
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Fort Pierce, FL 3'49$2
772-462-2-165 olr•772-462-2172
Fax:77.2-4fi2 6443.
(t04p'IN,90.ET1 N AFFIDAVIT
a. ,IF ( a`'�c�nsed'as>a�n ontracta". jEngineer/Architeet; •
(Please print name: c�r.¢te license:type) FS468 Building ICispe.c
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*General,8u�ttlrng�Res�dentra(o'riioofng co'f}crtYctdc orany,incf�irii�uaL certetl utidr4�8 F 5 to�rtpke such aC� nspecxio�r;
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.0 •oralsoutt�6/� [did personallyinspect the roofi deck.naiiin .
{Rated _ _ _
(iobb site address);
Based':upon that exarrnnattotr[haVdetermined the lmWlation was done accordingte the current I
edition:of the Florida Existing l ild`rng lode•Settlon,700 or the;product approval submitted(whichever
i mast strigept).
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Signature aind.eatJNTV
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,5w6m to and:suVsaribed before_inethEs^ .. day off_c�W3 _ 20jg r
bar , Who is
personally known tQ.�ne,ar u6o has rodelced
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:Notary;U-bti,.State of,Florld'a
Sigriature:of y n
Notary -,`
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Gotnmisston Number.:
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