HomeMy WebLinkAboutRoof Affidavit Planning& Development Services
Building&Code Regulation Division
2300 Virginia Avenue
® Fort Pierce, FL 34982
r - r= =- tlN 772-462-2165 or 772-462-2172
Fax:772-462-6443.
ROOF INSPECTION AFFIDAVIT
Re: Permit# ZdOZ— 0 Z 6�
I, 001q4j �1licensed 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 02` I Z/Z . 1 did personally inspect the roof deck naaM
(Date)
work at:� ��7��vc��
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of a Florida Existing Building Code Section 708 or the product approval submitted (whichever
isrtos tri n .
CCC-133 i/?d
Signature and License #
STATE OF FLORIDA
COUNTYOF /✓P
Sworn to and subscribed before me this 77 day of f—�/ 20_
by Z/,�W,0 1jJijl!,1&4 . Who is personally known to me or who has produced
�—as identi [cation. o a
OaN �
Notary Public,State of Florida m.y w o
Signature of Notary: m�z 0 N
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Commission Number: (Seal) ma
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65
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