HomeMy WebLinkAboutRoof Inspection Affidavit Planning int 111!!1?pili e—Unkes
iCOUNTY 7 23M Virginia Averme
„ Fort Pima,EL 349x2
a..n ,. 772-"2-2165 ter'3' 462-2172
Fax:772-462-6"3
I
� Re; Permit# 19Q9-04w
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I, " 4 4,wa,.,1J1.L,Hcen asa(n)Contractor"/Engineer/Architw
(Please print name&circle license type) *F5468 Bu"Inspector
*General,9ulldkV,ReV*ntkf or Roofing Cbmmctor or any indfi awl cer*W udder 4M F4 to mke such an hupe."ctian,
on or about . , ej ,I did Personalty inspect the E%Lf deck nailing
(Date)
work at; `74. r
(job site address)
Basest upon that examination I have determined the Installation was done according to the current
edition of the Florida Isting Building Code Section 708 or the product approval submitted(whichever
Is most strigent).
SI ure and Seal license#
STATE OF FLD 4 A
COUNTY OF rL
Swot`s to anp subscribed before this�_day of 2
by �-9 (LJV'J'&1 Who rs+ana p n o r who has produced
as ident kation.
' Ntztpry Public,State of Mori
S1960ture of Notary!
Commission Nu ( alp
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ADAM PALAv
Weida r tett Fubii"Wo at f»s .
ADAM kM AS co"iesko t GG 2M.+:
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04.2023
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