HomeMy WebLinkAboutRoof Inspection Affidavit Planning & Development Services
Building& Code Regulation Division
2300 Virginia Avenue
iCOUNTY Fort Pierce FL 34982
772-462-2165 or 772-462-2172 it
Fax: 772-462-6443FCFl
ROOF INSPECTION AFFIDAVIT
Re: Permit#
I,
21, licensed as a(n)Contractor*/Engineer/Architect
(Please print name& ircle 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 I `��`" I , I did personally inspect the roof deck nailing
(Date) n
work at: 36`t � 90X�Uccr2. a A-ye--c-
(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
�) 1331770
Signature and SAIJ License#
STATE OF FLORIDA _
COUNTY OF �T
Sworn to and subscribed Pefore me this��day of 20—M
by Who is personally known to me or w o has produced
Z- QUv— as identification.
Notary Public,State of Florida t r
Signature of Notary: v
Commission Number:
�pRYPVB� ELLEN VAU"GHN
?° :State of Florida-Notary Public
En �' 'c Commission #GG 270079
i9 ,fFuo��: My Commission Expires
�� Oetober 22 2022
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