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¢ 7 �-- Building& Code Regulation Division
® 2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2 2 R ECE r�
Fax: 772-462-6443
JL/Al2 20,E
ROOF INSPECTION AFFIDAVIT Sr' Lucie Oounrn
ty,per
Re: Permit# 1805 -023 7
I, Q-z hei-{ bi`I(0,1, licensed as a(n)(ont�ractoorr /Engineer/Architect
(Please print name&circle license type) *F 468 Building lnspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such on inspection.
On or about G / ( / 2-v i O , 1 did personally inspect the roof deck nailing
(Date)
work at:
(Job 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 708 or the product approval submitted (whichever
is most strigent).
o< CC-L. 133 ) 3c/8
Signature and Seal License#
STATE OF FLORIDA �
COUNTY OF ,Jk pyy ye-�..�
Sworn to and subscribed before me this day of � 20J2
by Who is ersonall to me or who has produced
as identification.
Notary Public,State of Florida
Signature of Notary:
Commission Number: (Seal)
En SALLY MEISNER
Pw LB
:State of Florida-Notary Public;:!
*= Commission#GG 192960 y
11Z My Commission Expires
ri March 06, 2022
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