HomeMy WebLinkAboutRoof Inspection Affidavit y 5�
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} Buiiding.& Code'Regulation<.Division
23O041*irginta Avenue i
Fort�:Pterce, FL 3498,
:. .. _... -772-462-21`69-',"or 772 462 2172,
} Fax 772-462 6443
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ROOFINSPECTIUN AttDAVIT �
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Re Permrt# 2.003$
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licensed as a(r)Conti-actor*/Engineer/Rrck�rtect t
(Ple se'pci6t name&circle Incense type) ; . *FS468:Buildmg:,Inspector j
General,8ufldrn :Resldentia!or Roo In Contractor or 6n Individual cert led under t6&,F S to make such an Ins actio».
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On or.aboufi Z"1. ,;ZO?,O. 1 did person i
L ally inspect'the roof deck naifin�
(Date)
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(!oh site address
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Based upon that examination f have determined the installation was done,according to the.current
edition of the;Florida.Existing Budding Code Section 708 or the'-product,approval submitted":(whicl 'e er
:fs most strigent). a
CC,C-1 2-651-
Signature and Seal License#
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STATE OF FLORIDA
.cob-R OF_�
Swor 'to and subscribed,before me this p .:day of2U ,
ey _i ,_ Whoispersonallyknowntome.orwhohas.pcoduced
as identification. �
Notary Public,Stat o or► a -- i
,Signature of tSotary' a ERAWE�RD
Cornission Number: ;(Sea!) C M�SSiOP1N�265o55
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=n PiR S October U3:2022
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