HomeMy WebLinkAboutRoof Inspection Affidavit l
Planning& Development Services
- 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, 1C A-4 licensed as a(n ontractor' /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 I Lq W 1 Sj I didersonall inspect the roof deck nailing
P Y P >'
( ate)
work
(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 strigent).
c;—' Yt0 - 7
Signature and Seal License#
STATE OF FLORIDA
COUNTY OF Q
Sworn to and subscribed before me this %' day of 20Lf
by 9 ECJ$Wx- -&-a @ 14-JAK JNho is personall o n to a or who has produced
as identification.
Notary Public,State of Flori �ly
Signature of Notary:
Commission Number: (Seal)'
En
AUDREY B.HUMPHREY
*; *, MY cOMMISSION#FF 174772
EXPIRES:March 6,2019
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