HomeMy WebLinkAboutRoof Affidavit 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
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ROOF INSPECTION AFFIDAVIT MAR 1 3�p1C
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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 3 — C1- I did personally inspect the roof deck nailing
(Date)
work at: D JS L--0fy\ISS S J 4 -4 1 (),-e.
(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).
Signature and Seal License#
STATE OF FLORIDA
COUNTY OF 5I LTJ[...2f
Sworn to af�d subscribed before me this 13 day of (Y�,t�C_C,{ 20_L�
by Who is personally known to me or who has produced
as identification.
Notary Public,State of Florida
Signature of Notary:
Commission Number: (Seal)
En
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URFORDNotary PublicGG 183217j1„ on Expires, 2022