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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 # {
i�ce'nsed as a(n)Cont�*/Engineer/Architect
(Please print name & circle license type) *FS468 Building Inspector
*General, Building, )Residential or Roofing Contractor or any individual certified under 458 F.S. to make such on inspection.
On or about I did personally inspect the roof deck nailing
(Date)
work at: I^. J
(Job site address)
Based upon that examination I have determined the installation was stone according to the current
edition of the Florida Existing Building Code Section 708 or the product approval submitted (whichever
is most strige
Signature and Seal License #
STATE OF FLORIDA
COUNTY OF
S am to and subs rjbedbeforfe me this day of 20--'U
byv Who isperson-ally Known 10 me or who has produced
as identification.
Notary Public, State o forida
Signature of Notary:'
Commission Number: ko (Seal)
y�rr notary public State of Florida
En Amanda P Sanderson
My Gc:inmission GG 231256
�p Expires04125RO22