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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# ou" 7nL
I,locc"( �- licensed as a( Contracto */Engineer/Architect
(Please print name&circle license typ *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 L 101F I did personally inspect the roof deck nailing
(Date)
work at: q 1GC.&Cur.�o. LcAr\e (TQ.
(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 stri ent)
(u wb� S6
i s e a d Seal License#
STATE OF FLORID
COUNTY OF ,
�Sw to ands spdbed before me this�� day of Oh- Cl 20
bY Who is personally known to me or who has produced
N-, as identification.
Notary Public,State of F
Signature of Notary:
Commission Number: (Seal)
En
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oto �s LASHAH VqIng M `
Notary=. • y Public-State of Florida
y '7m.Expires Dec 20,2018
„N Co ll � mmission#FF 177299
8 +tl through National Notary Assn.