HomeMy WebLinkAboutRoof Inspection Affidavit (2) 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
ROOF INSPECTION AFFIDAVIT
Re: Permit#
I Sr censed 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.
On or about %����'/ , I did personally inspect the roof deck nailing
(Date)
work at: S /9
(Job site add(ss)
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 strigent).
` 3 2-1 19-5
Signature and Seal License#
i
STATE OF FLO, A
j COUNTY OF
Sworn to and-subscribed before me this_�day of P.� 20ff
by"OV6 Cipe� Who is personally known to me or who has produced
as identification.
Notary Public,State of Flo ' ���� � ��,.
Signature of Notary:
Commission Number: C
s *COI VIISSION0G0256359
NOW
En ., c EXPIRES:Sept 9,2022
1 BMW Thou AM
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