HomeMy WebLinkAboutRoof AffidavitPlanning & 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
Re: Permit # / J6-7- 0411,3
�41
& - nsed as a(n)C ntract */Engineer/Architect
(Please print name & circle license type) *FS468 Building Inspector
*General, Building, Residential or Roofing Contractor or any individual certified under 458 F.S. to make such an inspection.
On or about 0 1 , I did personally inspect the roof deck nailing
(Da e)
work at:
(Job site address)
Based upon that exami ve determined the installation was done according to the current
edition of the Florida xisting Builds g Code Section 708 or the product approval submitted (whichever
is most stXigent).
Signature and Seal License #
STATE OF FLORIDA
COUNTY OF>�
Swof� to and subscribe before me this v� day of AL �_ 20/j, .
by r, ,/y! ,�C i fit/,S p�.fel ho is personally known to me or who has produced
as identification.
Notary Public, State of Florida /
Signature of Notary: �.�
Commission Number: (Seal)
vti+�r�'ww�
r�
En � Notary Public State of Florida
W)Sandra J Kenny
PIM901/3012 23 597