HomeMy WebLinkAboutRoof Inspection Affidavit _ Public Works Department
Code Compliance Division
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2300 Virginia Avenue
ICOUNTY
Fort Pierce, FL 34982 .
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772-462-2172 Fax: 772-462-6443
INSPECTION AFFIDAVIT
Re: Permit#
1, h.(0ya L,/ Syra vp^ > 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 l z �2 ZD/ �, I did personally inspect the roof deck nailing and/or
(Date) (circle those that apply)
secondary water barrier work'at: ,ZN00 /' �� /l xc� j 4
(job site address)
Based upon that examination I have determined the installation was done according to the
Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.)
�C /3A 7,IV2.�'
Signature and Sea License#
-ij 'Aquno:) aianj y4S
4U@W: leda(j 6uI144piad
STATE OF FLORIDA $(OZ 133Q
COUNTY OF SY IL44"e
Sworn to an ubscribed before me this /3 day of ;/fGE"/'�S� 20 (103AX333�
by b0� Fit�►s.e � Who is personally known to me or who has pro
as identification. ,
Notary Public,State of.Flonda
Signature of Notary:L _e- _
Commission Number: -V—k--46j6-2-'7111!T6 (Seal)
En 09/17/09 �7hemSB Smith
COMMISSION#GG27149
EXPIRES: 25,20
ftWed Thru Asrron Notary
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