HomeMy WebLinkAboutRoof Affidavit Planning& Development Services
S = - Building&Code Regulation Division
4= 2300 Virginia Avenue
Fort Pierce FL 34962 RFc
772-462-2165 or 772-462-2172 Fig
Fax: 772-462-6443 PPS; I'tAte
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ROOF INSPECTION AFFIDAVIT
Re: Permit# cX-DD1 L)1`1
'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: Q C�5
(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).
Signature and Seal License#
STATE OF FLO
COUNTY OF CM, �,Vl
Swern to and subs ribed before me his / day of 20 c�
by Who is personally Gown to me or vQb has produced
as identification.
Notary Public,State of rida
Signature of Notary':
Commission Number: a (Seal)
En xk" Notary Public State of Florida
Amanda P Sanderson
My.Commission GG 211256
' a a Expires 0412512022