HomeMy WebLinkAboutRoof Inspection Affidavit Planning & Development Services
Building&Code Regulation Division g g
® 2300 Virginia Avenue
MM Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#
licensed as a( ontracto /Engineer/Architect
(Ple se 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.
On or about / I did personally inspect the roof deck nailing
(Date)
work at:
' (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
is most stri nt).
Signature and Seal License#
STATE OF FLO DA
COUNTYOl' ✓r wC/
Sworn to and subscribed before this 7%ay of 20JI
by LLD &A( ?f-C Who is personally kno n to me or who has produced
Z as identification.
Notary Public,State of Flo
Signature of Notary: ��
Commission Number: Ca ® O .1 / (Seal)
EnMA F
MY cl $EN
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