HomeMy WebLinkAboutRoof Inspection Affidavit _ Planning& Development iservices
rY Building&Code Regulation Division
2300 Virginia Avenue
0 , Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#
"Z6sS hrOeolicensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle license type) *FS468 Building Inspector
*General,Building,Residential or Roofing Contractor or any individual certifred.under 468 F.S.to make such an inspection.
On or about 1 did personally inspect the roof deck nailing
(Date).
work at:
site ddress)
Based upon that examin have deter coed the installation was done according to the current
edition of the F a Existi gilding de Section 708 or the product approval submitted (whichever
is most ent).
Cc 1331ao�
ignat r d Seal License#
STATE OF FLO DA
COUNTY C i
Swor to and subscribed before me this day of 20__/,
by n5NA& SbIrO . Who is personally known o me or who has produced
as identification.
Notary Public,Staf rich
Signature of Nota
Commission Number:G--& 190 (Seal) "
En
LISA MARIE MOMMEONE
Notary Pubiic-State of Florida
Commission=GG 190497
'mak of
""'. My Comm.Expires Feb 27.2022
Banded through National Notary Assn.