HomeMy WebLinkAboutRoof AffidavitMEM Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
* Fort Pierce, FL 34982
_ - - 772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit # _5LC 4603 — QG3S
licensed as a(n)Contractor*/Engineer/Architect
(Please print name & circle license type) *FS468 Building Inspector
*General, Building, Residential or Roofing Can troctor or any individual certified on der468 F.5. to make such an inspection.
On or about 4 en J-,27- � ° I did personally inspect the roof deck nailing
(Date)
work at: /l,5- �2A_ALC gisA,lyn PaAd F�
(Job site address)
Based upon that exarnination I have determined the installation was done according to the current
edition of the Florida Existing Building Code Section 708 or the product approval submitted (whichever
is most stri ent
Signature af4Seal License #
STATE OF FLORIDA
CO[JNTY OF
Sworn to nd subscribed before me this 1 day of I�1 �4�_ 202
by �.[_! _r2 �! r ?- l f Who is personally known to me or who has produced
C_-e as identification.
Notary Public, State of Flori yJ�
Signature of Notary:
Commission Number: (r Z (Seal) ovft Rebekah A.Campbel
Y� State of Florida
En �j My �nk)n Expires 0810412023
aF Comiselon No. 00 336063