HomeMy WebLinkAboutelm ave affPlanning & 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 4t Z-
1, icensed as a(n)Contractor*/Enginee r/Architect
(Please print n e & circle license type) *FS468 Building Inspector
*General, Building, Residential or Roofing Contractor or any individual certified under 458 F.S. to make such an inspection.
On or about lQ I did personally inspect the roof deck nailing
(Date)
work at:
(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).
&jo�"
Signature and Seal
(7 CC l 6� i
License #
STATE OF FLO c1r n
COUNTY OF �/'l�
SW r t nd subscrib be re e his / day of 20zo
by Who is personaliy known o me or who has produced
as identification.
Notary Public, State of F
FIM
KATHERINE HAVENS
Signature of Notary:MyCOMMISSION #GG165030Commission Number: (SeaoP EXPIRES: DEG 04202... _
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