HomeMy WebLinkAboutroof Affidavit Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982 RECEIVEL
772-462-2165 or 772-462-2172
Fax: 772-462-6443 JUN 14 7018
Permitting Departmen
St. Lucle Countv
ROOF INSPECTION AFFIDAVIT
Re: Permit# �c 1865 -bss l
I,Te` �a�\S�t� , licensed 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.
6 On or about - - 1 , I did personally inspect the roof deck nailing
(Date)
work at: -7,57 kc,,rc,
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of the Flo xisting Building Code Section 708 or the product approval submitted (whichever
is most gent).
/ cas9
Signature and Seal License #
STATE OF FLORIDA
COUNTY OF
Sworn to and subjf ibed before me this_ �day of
by xC i'G�-1.5 e n Who is personally known to me or who has produced
l as identification.
Notary Public,State of Florida
Signature of Notary: f04-4 /�2/�.✓,f�✓I
Commission Number: Ir (Seal)
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