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Building&Code Regulation Division
•
1111 Virginia Avenue
�• NTY RID Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re:' Permit#
l,'&na 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 6I did personally inspect the roof deck nailing
1 ( te)
work at: L2jQq ZC.O,rA SCJ
(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 str' ent).
I
Ccs 1.I 14
Signature and Seal License#
STATE OF FLORIDA �,,,, ((��
COUNTY OF rk9-.y-t
Sworn t and subscribed before me day-o c v��tJ�r 20_1,
by ' (Fi' }9-is personally-k own to me or who has produced
as identification.
Notary Public,State of FI
Signature of Notary:
Commission Number: CSG I �i2�XZ (Seal) }r "'AFF Notary PublicStateotFloride
MY comm ssion GG 152882
En �p, Expires 10/18/2021