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
ROOF INSPECTION AFFIDAVIT
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Re: Permit# /I/6:L — F �
I, t , 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 C--�5 — I c/ I did personally inspect the roof deck nailing
(Date)
work at: 'r: �i--'✓I#4✓)-1 /'7/ P,y, eco
(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= �' 0 c e /3 3//-7v
Signature anAal License #
STATE OF FLORIDA
COUNTY OF
Sworn to and subscribed before me this -7 day of SVnJ G 20H =`►��•ra`9
by 4//4s✓D Z /j,64 Who is personally known to me or who has produced
as identification nK0 m =
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Notary Public,State of Flori a c 3 w '-'_
Signature of Nota ��.� 1 m 3 ° ° m
Si Notary: <w- n�
Commission Number: (Seal) rnLA o *`zW
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