HomeMy WebLinkAboutAffidavitPlanning & Development Services
j _ = Building & Code Regulation Division
i 2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit #1"I �/ V
c,�q�� ccs )Co
ensed as a( ntractor* ngineer/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
( ate)
work at: &GO dCQ - S-7-, -P4 75'� Ua-e P—,jV1W?-
(Job site address)
Based upon that exami e det rmined the installation was done according to the current
edition of the FI a Existi uilding de Section 708 or the product approval submitted (whichever
is most str' nt).
re and
STATE OF FLORIDA
COUNTY OF<S U& C. bf _
License #
Sworn to and subscribed before me this _ day of 1AjIlonbLe,ms 20
byjSh,:ja �)C,,h rese who is personally known to me or who has produced
as identification.
Notary Public, Staida- -
Signature of NotaMr
Commission Number:C- C`) �l 7 (Seal)
En
LISA MARIE MONTELEONE
>zY .
Notary Public - State of Florida
Commission # GG 190497
My Comm. Expires Feb 27, 2022
""" Bonded through National Notary Assn.