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` ~ Building&Code Regulation Division
2300 Virginia Avenue
ID w Fort Pierce,FL 34982 FFEB
IVED
- - 772-462-2165 or 772-462-21722 2020
Fax:772-462-6443ty,, Permitting
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ROOF INSPECTION AFFIDAVIT
Re: Permit# 5(- 2_�0
I L IV1c("414 .licensed as a(n)Contractor*/Engineer/Architect
(Please print name&,circle license type) *FS468 Building Inspector
-General,Building,Residential or Roofing Contmcror or any individual certifPed under 468 F.S.to make such an inspection.
On or about IkIZICIZ I did personally inspect the roof deck nailing
( ate)
work at:
70°3 C, e...•' 99 tc�(4 R
(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 Se, } License#
STATE OF FLORIDA
COUNTYOF S-i- l-1,C.ae
4 C cL+Y
Swo[�to and sub cribed before me this { day of � 20 20
by 1Pwho is wzersgna k oven to me or Who has produced
as identification.
Notary Public,State of ;Gn,,� DANIELLE P.ZfiViM�Sj `i.
Signature of Notary: �w+N �' _ ° state of Fioride-Nalco Pk6.�E
•_ commission 8 GG 1£16,44"
Commission Number. (S �;', Qc My commiisoW gifts
September 09,_
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