HomeMy WebLinkAboutRoof Affidavit Planning& Development Services
Building&Code Regulation Division
COUNTY 2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
RECEIVEO
CC OCr 2 s 7#1R
Re: Permit# T O '10 �-oli Ica Pea ittrng Oe
Ducie Pdr7n�:
I, t licensed as a( Contractor* Engineer/Architect co,
(Please prAnt 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 I D/-as�� I did personally inspect the roof deck nailing
(Date)
work at: I a03S S lr--IcLn
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of the Florida Existin ding Code Section 708 or the product approval submitted (whichever
is most st
Cr-13 '�-1
Signature and Seal License #
STATE OF FLO IDA
COUNTY OF b 1
Sworn to and subscribed before me this CZS day of UG{ul�e.r 2p
by ).et4vtx, Al ✓k Who is personally known to me or who has produced
as identification.
Notary Public,State oflorida
Signature of Notary:
Commission Number: o$ ' (Seal)
En
E41 004p,
Notary Pubk State of Florida
Stephanie Rodriguez
My Commfss GG 108602
� :)Ores 05/25/2021