HomeMy WebLinkAboutSLC 2003-0519 AffidavitPli Cu� C o G�
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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 # S L G Z 0 0 3- US ►'r
(,C4- V-1 p, icensed as a )Contractor* ngineer/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 .3 115 � "Z-d i did personally inspect the roof deck nailing
(Date)
work at: e0"v t) e2 t I2LA- n Q r -
(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).
��'4 --�
Signature and Seal
STATE OF FLORIDA
COUNTY OF • LtA &l {J
CCC 13 z 8 S9 I
License #
swor o and sub ibed before me this _ G _5_._ day of M C —V- LV1 2D�
by e n Who is -personally know_ n to me or who has produced
as identification.
Notary Public, a ft�0
Signature of No ry:Commission Number: (Seal)
En
`,,,,YP�,,� LISA ANNE PET'ERSON
io`4� 'i" State of Florida -Notary Pubft
+= Commission # GG 220717
_* -
,. s`: MV Commission Expires
'`;;°F;;:�'� September 1b, 2022