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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# I 61 -0414
1, Christopher Collins , licensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle license type) *FS468 Building Inspector
*General,Building,Residential o Roofings Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about6 I did personally inspect the roof deck nailing
(Date
work at: .� .
(Jo site a dress)
Bas d upon tha a in tion I have de ermined the installation was done according to the current
e ition of th rida isting Bjodin ode Section 611 or the product approval submitted (whichever is
ost strig
CCC-058011
ture a S License#
STATE OF FLO
COUNTY OF �
Swor,Q o a d ubs ibe before me this ��/ day of 20 ',
by V7 c1 . Who is personally known to rrIe or who has produced
!, t U as identification.
Notary Public,State of Florida
Signature of Notary:
Commission Number: "V"`'f.'""" ULLINUADAKULN (Seal)
Fy PEibk Stale of Florida
Commission k GG 169025
En 01/19/2011 -"^;' •y My Comm.Expres Dec 18,2021
;0� ,M';
... Boi�ifxl through National No!aryAssn.