HomeMy WebLinkAboutRoof Inspection Affidavit _ Planning& Development Services
'' Na"W Building&Code Regulation Division
<' M 2300 Virginia Avenue
UNTY
+ Fort Pierce,FL 34982
772-462-2165 or 772-462-2172
Fax:772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# k 1 "'o 51
I, William Lasky Jr. ,licensed as a( )Contractor /Engineer/Architect
(Please print name&circle license typ *F5468 Building Inspector
*General,Building,Residential or Roofing Contractor cr any Individual certified under 468 F.S.to make such an Inspection.
On or about . I did personally inspect the roof deck nailing
{bate)
work at: 12 Crown Ct Ft Pierce, FI 34949
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of the Florida EXI., ' g Buil Ing Code Section 708 or the product approval submitted (whichever
is mos trigent). /
CCC 1326188
Signature and Se License#
STATE OF FLORIDA �61,
V`�`-� L;ced
���r t� r COUNTYOF 1z `+
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Swo to and ubscribed b fore me this day of 20
NOV 2 7
by u I i U'S 3c Who is personally known to me or who has proLD)9
as identification. ng Department
Notary Public,State of ie County, FL
Signature of No r
Commission Number: (Seal)
En
r'%�n.Y?{q•; DEBORAHL.AUSTIN
Commission 9 GG 165615
q Expires January 8.2022
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