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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
Re: Permit # / q0D — 61 -7 �
I, 1! l✓ilicensed as a(n ontractor /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.
6 On or about — o -1� , I did personally inspect the roof deck nailing
(Date)
work at: 603/MaomdA,A en,-- f-� P3,-erg.L
(Job site address)
Based upon that examination I have determined the installation was done according to the current
editio �gjlorida Existing Building Code Section 708 or the product approval submitted (whichever
is most s iR %
Signature and
STATE OF FLORIDA
COUNTY OF�c
Cat �33117D
License #
rn to and subscribed before me this IQ day 2019
W�SIs�. Who is personally k own me or who has produced
"rL. QA--4. U as identification.
Notary Public, Sta i
Signature of Not `
Commission Number: (Seal)
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