HomeMy WebLinkAboutRoof Inspection Affidavit Planning& Development Services
Building&Code Regulation Division
2300 Virginia Avenue
' COUNTY
F L 0 R I D A Fort Pierce, FL 34982 111
772-462-2165 or 772-462-2172 04%Z,�n
Fax: 772-462-6443 stzrh9
ROOF INSPECTION AFFIDAVIT
Re: Permit# /90 F(- 0691
i, iS�caG 4� ense 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 468F.S.to make such an inspection.
On or about.- I did 'personally inspect the roof deck nailing
(Date) I
work at: �713 Dud, E-r R 3q-,�r,-F
z�
(Job site address)
Based upon that examin av er fined the installation was done according to the current
edition of the Fl xisting ll g de Section 708 or the,product approval submitted (whichever
is most st i nt).
gnature and Se-al License#
STATE OF F I
COUNTY GJ
ove me this day J
Swo tqqand,=suc ed bef 4&ke??A4T-20Lj
Who rio�vn to me or who has produced
b is personally k
as identification.
Notary Public, tate o ida c
Signature of No
Commission Number. I 0'rf q� (Seal)
En
IE MONTELEONE
ft Not.
ublic-state of Florida
C. -or,,GG 190497
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97
Co resk
-b27,2022