HomeMy WebLinkAboutRoof Inspection Affidavit r
M
�Plartnan & V- 176. men Seances
s
,�uit�>ng&Code RegutatranDiv�siori3L IE `
3
230f1 TY
Vltrginia Avenue
., -
�, ,= ForEtR�erce,�Ft 34982
r t t
461-
7 7 2
62772 462 6443' ;
.R
ROOF'INSPECTION'AFFIDAVIT
r
'\,• 3 +'w
I, ,tS tn�i'ier, licensed as a(n Contractors`/Engi_eertArchttect`
Please tint name&c�rcfe license ped *P-5,468 Bu�ld►ng Inspector a
( p 1 .
*General,eurlding,Resdeatrai or Roofing-Contractor orany indrvTdualtsnkied ua'der 458 FS to mdke such nn rnspeettort
�t l z�? I did-persorall� ins ectithe roof deckna�lne
,
On or about;
- t
p 4,
, 41
(Dated
}
work ati?
M.
845 SEtiFestivo Court,part St Lucte,rFL 34983 f
site add�ress�`
llatign wa
Based exarnlnation I:have determined tie insta 'dorcor
ie"acding to the'current A
.r,
ed�ttorlofthe Florida Existing t3ultdrng Code Section 708or the;product appravalsubmltted (whtchaver
:r
is most strige � J ?, T - -
t
CCC133�14 ' • ,
Si nature and Seal _
g
• Llce a#�
e t
-ST-ATE.OF FLORID ;
COUNTY OF.
Sworn o and su crbed before me`this day of -
20. 4
77777
Who'►s aersonally known to me or.'who has produced ,
,
" - NotaryPubhc.State:�of Florida � " .
Signature of Notary 17 {
Comimssion Number
Q aq
(5e
x
Ar>
2029
1 4
v. a
Y
. ,
r
7 i