HomeMy WebLinkAboutRoof Inspection Affidavit ,
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Planning& Development Services LL' n
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�u�lding&Code Regulation Division
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--ROOF INSPECTIONAFFIDAVIT
Re .Permit#
I; � r�rr�tP,hS{ , licensed as a ntractot` / ngtneer/Arci�rtect
` '(Please prtntrname&circle license ty - *FS468 Building inspector
' `General,$Su(lding,ReSiden�ra(o� oofing Cotrfrgctor ar ny lndivdua!ceftrfled unde468 F S:to make such qn rnspect►on ,
a, Qn=ortabout 2 I2oZ0 I drd;personally inspect the roof decksnarlrne;
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'T(Datell-I
(Job-s'ite address)
Based'upon that examination,I have;determined the installation was done accordingto"ttie current
4� edition of{the Florida Existing Bualidrng Code Section 7080t the product approval suUrnitetl{(whicheyer
Isi MOSTstrigent) =
Si'nature and
g.. License# .,
STATE OF FLORIDA: '
c0_(J,NTYOF C+° IAC'I�
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Sworn to and subscnbed,before me hiss^ day of = 207 ,
by CfilutYh (fiYC'- -�1YISf[N1S�Y� Who is personally[mown to me or Who has produced
_3 s r _ E _ i y t,.1 • _
- as identifica ion
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Notary Public,State of orida -
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Signature of Nota t r ,
Commission Number r7f7 29R LFiD 1 (Seal)
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