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��-r- Building&Cod Regulation Division
COU TY 2300 Virginia A enue
Fort Pierce, FL 4982
- - 772-462-2165 r 772-462-2172
Fax: 772-462-6 3
I. ROOF INSPECTION AF IDAVIT
I
Re: -P termit# I ZCJ]`0Z.(�j
1, Christopher Collins , licensed as a(n Contractor* Engineer/Architect
(Please print name&circle license type) * S468 Building Inspector
*General,Building,Residential or Roofing Contractor or any individual certified nder468 F.S.to make such an inspection.
On or about - zoa I did personally inspe(t the roof deck nailing
(Datil)
work at: el
i
(Job site address)
sed upo at exa ination I have etermi.ned the installation was done according to the current
edition the ri Existin uildin Code Section 611 ort a product approval submitted (whichever is
most s ri
CCC-0$801 1
j Signature nd Seal License#
STATE OF FLORIDA
COUNTY OF
Swo to a d ubs i d before me this day ofV20
by 5 " �9 Who is personally known to me r who has produced
0—C452fl h as identification.
! Notary Public,State o,,rl
Signature of Notary: :'s�``�- CV Nhlec DfNafioaaftlary
Commission Number +�'` Commissio (Seal)
Z,r y omm. x021
Bonded through sn.
En 01/19/2011