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= Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-452-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit # 1903-0504
1, Dee Keihn , 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 on inspection.
On or about 3/24/2019 1 did personally inspect the roof deck nailing
(Date)
work at: 110 N 39th Street Fort Pierce, FL 34947
(Job site address)
Based upon that examinalon 1 have determined the installation was done according to the current
edition of the Florida Exit ng Building Code Section 708 or the product approval submitted (whichever
is rrL63� strigen
CCC1331408
ture and Seal License #
STATE OF FLORIDA
COUNTY OF Saint Lucie
C
Sworn to and subscribed before me this day of : 11,q v' G 20LY
by I cc- I[ e r 4 Who is personally known to me or who has produced
j as identification.
Notary Public, State of Florida y�
Signature of Notary: E
WCHELLE GREEN
Notary Public - State of F{arida
Commission Number: (Seal)
My Comm, Expires Oec 20, 2022
Commission A GG 285318
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En Banded through National Notary Assn,