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 # / qA-_"' v )� 9
I�Sh�1G,SeY1ra�censed 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 /q LZ01'? , I did personally inspect the roof deck nailing
(Date)
work at:
Based upon that examir
edition of the FI ' a Ex
is most str' nt).
nature and
STATE OF FLORIDA
COUNTY OF<S-�fil,-�
S Cry, r! relcC-
(Job site address)
av-e-d--e-t rmined the installation was done according to the current
ilding qbde Section 708 or the product approval submitted (whichever
License #
Sworn to and subscribed before me this _ day of Deem UL1--20jg
Who is personally known to me or who has produced
as identification.
Notary Public, Sta rida
Signature of Nota a
Commission Number: t��1 (Seal)
En
�aiir'a�dl
. '
LISA MARIE MONTELEONE
Notary Public - State of Florida
9 GG 190497
Qe
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Commission
My Comm. Expires Feb 27. 2022
""" Bonded through National Notary Assn.