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I 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 # SLC2004-0045
I PaulBange ,licensed as a(n)Contractor*/Engineer/Architect
(Please print name & circle license type) *FS468 Building Inspector
*General, Building, Residential or Roofing Contractor or any individual certified under 468 F.S. to make such an inspection.
On or about 04/21/2020 1 did personally inspect the roof deck nailing
(Date)
work at: 7576 South US 1 Bay 22
(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 rigetlt),
gna ure and So I
CCC033691
License #
STATE OF FLORIDA
COUNTY OF ��^^
Swor o and ubscrib d before me this day of 20.�1
by . Who is personally kn n to me or who has produced
as identification.
Alt
Notary Public, State of FI dAl
Signature of Notary:
Commission Number:
En `',
�• �;• MYCOMMISSION N GG 918438
%'1•'EXPIRES: Aprils2024
' r �t Bonded Tlw Ndvy Public Undemium