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a r Building& 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# 190—69
I, ieensed 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 *QWl" ?—OSA , I did personally inspect the roof deck nailing
(Date)
work at: Fl`�— Plerce I 1�tI
(Job site address)
Based upo Fthat examination I have determined the installation was done according to the current
edition of he Florida Existing Building Code Section 708 or the product approval submitted (whichever
is most str gent).
Sign ture and Seal License#
STATE OF FLORIDA ,.
COUNTY OF
Swor to and subscribed bef re me this �/ day of 20 �
by-3014 .11zh eo bgtk; Who is personal k o n o rvKor who has produced
as identification.
Notary Public,State of Florida
Signature of Notary: 5�
Commission Number: V (Seal)
En
y' AUDREYB.HUMPHREY
YP
MY COMMISSION#FF 174772
?,: a EXPIRES:March 6,2019
Bonded Thru Notary Public Underwriters