HomeMy WebLinkAboutRoof AffidavitRe: Permit #0 D
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
ensed as a(n)Contractor*/Engineer/Architect
(Please print n]ame & 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 D�I did personally inspect the roof deck nailine
(Date)
work at: ��r)-
(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 strigent).
Signature and Seal
STATE OF A FLQPI
COUNTY OF �1 � ulC t 6-
License #
-5
--5 r6no d suit cr' ed before me this day of �� ' �IV 11
20 li �A^
,Zr
V ����. Who is personally known to me or who has produced
as identification.
Notary Public, State of Flgrida
Signature of Notzry: i T(�
Commission Number `b
(S'" KATHERINE HAVENS
MY COMMISSION #GG165030
En
EXPIRES: DEC 04, 2021
' Bonded through 1st State Insurance
c i
� a
Re: Permit #0 D
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
ensed as a(n)Contractor*/Engineer/Architect
(Please print n]ame & 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 D�I did personally inspect the roof deck nailine
(Date)
work at: ��r)-
(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 strigent).
Signature and Seal
STATE OF A FLQPI
COUNTY OF �1 � ulC t 6-
License #
-5
--5 r6no d suit cr' ed before me this day of �� ' �IV 11
20 li �A^
,Zr
V ����. Who is personally known to me or who has produced
as identification.
Notary Public, State of Flgrida
Signature of Notzry: i T(�
Commission Number `b
(S'" KATHERINE HAVENS
MY COMMISSION #GG165030
En
EXPIRES: DEC 04, 2021
' Bonded through 1st State Insurance