HomeMy WebLinkAboutRoof AffidavitCOqRNTY
F L I D A
Re: Permit # iaci -t n?A
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
! Dee Keihn , licensed as a(n)Contractor*/Engineer/Architect
/ (Please print name & circle license type) Yp ) *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 ola , I did personally inspect the roof deck nailing
(Date)
work at: 7234 Mystic WAY Port Saint Lucie, FL 34986
Based upon that examinatio
edTst
if the Flori a E ' irk
is s rigen*-
Signatur, and Seal
STATE OF FLORIDA
COUNTY OF
(Job site address)
determined the installation was done according to the current
ng Code Section 708 or the product approval submitted (whichever
CCC1331408
License #
Sworn to and subscribed before me this day of On,r,l,i ZpG1
by 7 r �Y' Who iszl kno n tome or who has produced
entifi ion.
Notary Public, State of FI
Signature of Notary:
Commission Number:
(Seal)
En
(ALViN RODRIGUEZ JR.
r�i n t+AY commissl0
0
#GG327319
EXPIRES: APR 24. 2023
Banded through ist State Insurance