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11 Planning& Development Services
Building&Code Regulation Division
2300 Virginia Avenue RECEIVED
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172 OCT 2 9 2018
Fax: 772-462-6443
ST. Lucie County, Permitting
ROOF INSPECTION AFFIDAVIT
Re: Permit# /X tO ®,S—��O
I, ��✓ � , licensed 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 /D-?9✓tg , I did personally inspect the roof deck nailing
(Date)
work at: [67(g9 (2541�OCA- a7%L ULtSe-
(Job site address)
Based upon that min tion I have determined the installation was done according to the current
edition o arida Exist
Building Code Section 708 or the product approval submitted (whichever
is most tri nt).
Signature and Seal License#
STATE OF FLORID
COUNTY OF L (tom
Sworn to and sub ibed before me this day of ('—a!-Q 'Q(' 20_
by 1, .0 in,A!0 Who is personally known to me or who has produced
"3 1 as identification.
Notary Public,State oFlor' a
Signature of Notary:
Commission Number: (Seal)
En A „` RENEE PHILLIPPE
Notary Public,State of Florida
as
Commission#GG 179276
My comm.expires Mar.4,2022