HomeMy WebLinkAboutRoof inspection affidavitSworn tq�� s � ,gib;
by 'L
Notary Public, State
Signature of Notary:
orrmi'ssion Nurnbe
En
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce., FL 34982
772-462-2165 or772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit
I, i licensed as a(n)Contractor*/Engineer/Architect
(Please print name & circle license type) *F5468 Building Inspector
General, Building, Residential or ftofing Contractor or any individual certified under 468 FS tcrake s u ch an ib p ec ti an
On or about
(Date)
22 VZ)
work at: ->
1
I did per5anally inspect the roof deck nailiniz
(Job site address
Based upon that examination I have determined the installation was dons according to the current
edition of the Florida Existing Build-Ing Code Section 708 or the product approval submitted (whichever
is most strjgent).
I
Signature and Seal
STATE OF FLORIDA
COUNTY OF C I
'IQ� � r . I��s i � day of 2�oL�
rrt) Who is personally known to me or who has produced
as identification.
license ft
of FI
r: J �" Sea!)
KATHERINE HAVENS
MY COMMISSION #GG165030
er
or
EXPIRES DEC 04. 2021
80(*d 1111OUgh Ist Stale Insuiancd