HomeMy WebLinkAboutAffidavitl-lacmgn p PA - Dajlj
t Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
h Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# aoo3` 0300
I, 0-4.q , licensed as a(n ontractor* Engineer/Architect
(Please print name & circle license type) *FS468 Building Inspector
*General, Building, Residential or Roofing Contractor or any individual certified under468 F.S. to make such an inspection.
On or about H I I o I -�D , I did personally inspect the roof deck nailing
(Date)
work at: LA pkQ u
(Job site address)
Based upon that examination 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 strigent).
rD" . R i2��
Si Lure and Seal
STATE OF FLORIDA
COUNTY OF /�-�FiR•" fz,+v
License #
Sworn to and subscribed before me this l �� day of ���zL 201
by _ oi,,G„�-� tai , Who is P sonally known to me or who has produced
as identification.
Notary Public, State of Flori
Signature of Notary:
Commission Number: (Seal)
t
En
KEGAN CRAWFORD
My COMMISSION 4 GG265055
�F�� EXPIRES' October 03, 2022