HomeMy WebLinkAboutRoof Affidavit Planning& Developmerrt Services
Building&Code Regulation Division
2300 Virginia Avenue
Fort Pierce. FL 34981
or
Pan:772-462-6443 9,ecelk%jet)
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ROOF INSPECTION AFFIDAVIT oepartment
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Re: Permit#
licensed as a(n)Contractor�Engineer/Architect
(Please print name circle license type) FS4-6-9B—u ird—Ing—inspector
"General,Building,Residential orRoqjfing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about -3 16 1 did personally inspect the roof deck nailing
(Date)
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work at: 7-e
'T(, I ,
(Job site address)
Based upon that ex,amination I have determined the installation was done according to the current
edition of the Florida Existing Building Code Section 611 or the product approval submitted (whichever is
most strigent).
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Sir6'p�--n Seal License fi
STATE OF FLORIDA
COUNTY OF
Sworn to and2bcribed 4tfore me this I LO day of Idl-11 201
by Who is personally known to me or who has produced
as identification.
-Notary Public,State of Florid I
NSignature of Notary:
Commission Number: (Seal)
En 01119/2011