HomeMy WebLinkAboutRoof Inspection Affidavit Planning& Development Services
rf, ifBuilding&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#� 1906 CO 3
1. BA icensed as a(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 /^ cz 1 did personally inspect the roof deck nailing
(Date)
work at: Lr17 (3&44-<--i-4 Al 1
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition o he Florida Existing Building Code Section 708 or the product approval submitted (whichever
ism t stri ent).
ignature and Seal License#
STATE OF FLORIDA
COUNTY OF c1 J
Sworn to and subscribed before me this day of �.�Ut AC5 0:-- 201,
by�GC(LI L A 4C6,A 1 Who is personally known to me or who has produced
as.identification.
ItRY rUyy_- DESORAN RAE COURTNEY
Notary Public,State of Flori ,r . * commWicn#GO 11529E
,Signature of Notary: °; e"` ExPk"JWN15,202!
Commission Number: (Seal) '�or �o- drhv8,da,t �.,tc+.
En
JUN 05 901.1
Permitting L:jt p;,3rt-rnt?r'=r
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