HomeMy WebLinkAboutRoof inspection affidavit12
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-4-62-2165 or 772-46E-2! 22
Fam 772-462-6443
ROOF INSPECTROM AFFIDAVIT
Re: Permit,,/�� V-3 i3
1, 6 (��� � licensed as a(n)Contractor*/Engineer/Architect
(Please print name & circle license typef *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 f ';t-o I did personally inspect the roof deck nailing
(Datel It
work at: %6 �?` �. C11174/
(Job site address) 3 Y 9917
Based upon that examination I have determined the installation was done according to the current
edition of the Florida Existing Building Code Section 611 or the product approval submitted (whichever is
most strigent). p
Si ature and Seal License k /
STATE OF FLORIDA
COUNTY OF
Sworn to and? subscribed before me this -'I'� d y of
b, -/���( � _. Who is personally (mown to me or who has produced
as identification.
I l Notary Public, State of FI�
(/yam Signature of Notary:
Commission Number. (Sea[)
En 01/19/2011
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