HomeMy WebLinkAboutRoof Inspection Affidavit (2) Planning& Development Services
Building&Code Regulation* Division
2300 Virginia Avenue
i . I , Fort Pierce,FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re:_ Permit#s 0,5 -0od,3
hrriicensed as a(n Contractor* Engineer/Architect
(Please print name&circle license type) *FS468 Building Inspector
*General,Building,Residential or Roofing Contractor crony individual certified under468 FS.to make such an inspection.
On or about Jam" r 3`c9lOa c7 I did personally inspect the roof deck nailing
(Date)
work at: tjtt12-A 1-50 i6?E , l�5 L V-Lx 3"?t..3
(lob site address) .
Based upon that exammat' ha ete fined theinstallation was done according to the current
edition of the Flo ' xisti 'din ode Section 708 or the product approval submitted(whichever
is most str' t).
Signature and Sea License#
STATE OF FLK7�7A
COUNTY OF �1�
Sworn to and subscribed before me this 1'9 day of � 20e
by3 tul� t, hraec.¢ ersonal
Who is ply known tome or who has produced
as identification.
Notary Public,Stat f rida
Signature of Nota
Commission Number:G6-19t 'y (Sea()
En
LISA MARIE MONTELEONE
Notary Public-State of Florida
Commission#GG 790497
tiyf My Comm.Expires Feb 27.2022
Bonded through National Notary Assn.