HomeMy WebLinkAboutRoof Inspection Affidavit Planning & Development Services
�- Building& Code Regulation Division
2300 Virginia Avenue
oFort Pierce, FL 34982
_--------__. ._. .._ __ 772-462-2165 or 772-462-2172
Fax: 772-462-6443
-141vROOF INSPECTION AFFIDAVIT -s'7)-eu d X20
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I, L&V'yYi0 -)14114 licensed as a(nContractor /Engineer/Architect
(Please print name&circle license type *FS468 Building Inspector
*General,euildin l Residential or Roofing Contractr any individual certified under 468 F.S.to make such an inspection.
On or about I did personally inspect the roof deck nailing
(Date)
work at: /2 s 71 /k Pa 67- 65F?db I-e2-6,ti
(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
ism strig ).
Signur and Seal License#
STATE OF FLORIDA
COUNTY OF !�—k •
Sworn to and subscribed before me this day of20�
by Who is personally known to me or who has produced
as identification.
Notary Public,State o" lorida ,
Signature of Notary:
ry' DEANNA MARIE GIVENS a
Commission Number: G6 dam = >(ft OMISSION#GG 022023 h
EXPIRES:December 16,2020 1
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'•.;oF F�?,••`, bonded Thru Notary Public Underwriters