HomeMy WebLinkAboutRoof Affidavit Planning & Development Services
Building & Code Regulation Division
® 2300 Virginia Avenue
o Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443 RECEIVED
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ROOF INSPECTION AFFIDAVIT- St. Cuce c Un ment
Re: Permit# 020 D
1,,;o—HIJ bcla-,-M licensed 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 , I did personally inspect the roof deck nailing;
(Date)
.work at: /off !� Gov�i/1y 6f'19/5e ✓ Z-A-/
(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
is most strigent).
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Signature and Seal License#
STATE OF FLORIDA Q -
COUNTY OF�Q_k,-Y-)
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SwQ.r�rto nd subscribed Q gene this 1� ,, day of rig 20
b ".� �� Who is personally known to me or who has produced
a ✓Rf' a identification.
Notary Public,State of Florida
Signature of Notary:
Commission Number: ( " "• JONALAHMWEBSTMER
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