HomeMy WebLinkAboutRoof Inspection AffidavitPlanning & Development Services
Building & Code Regulation Division
COUNTY 2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#1004-064'7
I, Dee Keihn , 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 05 0!;how , I did personally inspect the roof deck nailing
(Date)
work at: 360 Barraclough St Fort Pierce Florida
(job site address)
Based upon that examinatio 1 have determined the installation was done according to the current
editio of the KZ7
de Section 708 or the product approval submitted (whichever
is pst rigen
CCC1331408
Signa a and Seal License #
STATE OF FLORIDA ,
COUNTY OF 57_ Lu L -r—
Sworn to and subscribed before me this day of Nk- 20 _!�3
by -e- i(/" n Who is personally known to rIne or who has produced
as identification.
Notary Public, State of
Signature of Notary:
Commission Number: t—
En
(Seal)
ALEXANDER AGUWM
COMMIS$** li GG 23481 f
EXPIRES: July 4, 2422
Thru N "Public Ur&rwr#M