HomeMy WebLinkAboutRoof Inspection AffidavitPlanning & 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,T�r � r aj icensed 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 j i' f& q , I did personally inspect the roof deck nailing
(Date)
work at: 00 10Ne E7 PlerQe iF[- ZgFs-Z,
(Job site address)
Based upon that exami bion -F1 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 stri nt).
anature and S License #
STATE OF FLORIDA
COUNTY OF<S'!
Sworn to and subscribed before me this _ day of ��Oi/e/i'4bX1 20-)�l
by_S�Li��l ro�tL%n� Who is personally known to me or who has produced
as identification.
Notary Public, Sta o rida-
Signature of Nota
Commission Number��- t ��1 (Seal)
En
EW,
LISA MARIE MONTELEONE
Notary Public - State of Florida
commission #GG 190497
My Gomm. Expires Feb 27, 2022
Bonded through National Notary Assn.