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j - 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 #
I,DO-e- VttV , , licensed as a(n)Contractor*/Engineer/Architect
(Please print name & circle license type) *FS468 Building Inspector
*General, Building, Residential or Roofing Contractor or any individuaf certified under 468 F.S. to make such on inspection.
On or about f 2� "L� , I did personally inspect the roof deck nailing
(date
work at: i 9 S U-6-5 O ULS, CK, �nSeuA +3ec� rL - 00
(Job site address)
Base on that ex in ion I ha a dete ned the installation was done according to the current
edi ono the Flori a sting Buil Code Section 708 or the product approval submitted (whichever
is. t st i nt).
ienature n Seal License #
STATE OF FLORIDA
COUNTY OF S j . L-kkU C—
Sworn to and subscribed before me this 3� day of r k 1 20 a9
`
by D2 e � h n . Who is personally known to me or who has produced
Kr-� C\ as identification.
Notary Public, State of FI ri
Signature of Notary:
Commission Number:
En
(Seal)
ALF.XMOF-R ACUME
MY COMMISSION # GG 234811
d EXPIRES: July 4, 2022
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