HomeMy WebLinkAboutRoof Affidavit Planning &Development Service�ss
Building& Code Regulation Division
® 2300 Virginia Avenue
o D Fort Pierce, FL 34982
- 772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#
1 lam' licensed as a(n)Contractor*/Engineer/Architect
(Please print name &circle license type) *FS468 Building Inspector
*General,Building,Resi
dential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about Idid personally inspect the roof deck nailing
(Date)
work at: �//� �z7��; dlC�i 6j-zc le f Liet
(Job site address)
Based upon that examination I have determined the installation was done according to the current
T
e Florida Existing Building Code Section 708 or the product approval submitted (whichever
).
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Signature and Seal License#
STATE OF FLORIDA
COUNTY OF L tj 6224
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Sworn to and subscribed before me this 2,yb day of 20�
by �O// �� L=S j/i,. Wh ersonally known o me or who has produced cn
as identification. ! o m
Q 3 o D
a o _. —I
Notary Public,State of Flori a 3 N s=
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Signature of Notary: < y= a
Commission Number: 41Z (Seal) M o c o C
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