HomeMy WebLinkAboutRoof Inspection 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
RE
ROOF INSPECTION AFFIDAVIT
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Re: Permit# o �
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.
0 ' l�- J On or about I did personallyinspect the roof deck nailing
n (Date)
work at: 9 52CtC. 40!2
(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
i ost ri n ).
W=:��=.. -- - CCS 1331(-70
Signature and Seal License#
STATE OF FLORIDA
COUNTY OF S
Sworn tond subscribed before me this da i of X/ / 20Z� 01y N,
by �/�r�?7 Who is personally known -o me or who has produced =
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Notary Public,State of Florida7—°o m
Signature of Notary: 3
Commission Number:_
(Seal)
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