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-- Building & Code Regulation Division
2300 Virginia Avenue
A Fort Pierce, FL 34982
- 772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit # 1911 ��7
I, ,licensed as a(n) ontractor Engineer/Architect
(Please pr t name & circle license type) *FS468 Building Inspector
*General, Building, Residential or Roofing Contractor or any individual certified under 468 F.S. to make such on Inspection.
On or about 5 Doe , , 1 did personally inspect the roof deck nailing
(Date)
work at: P \ a, R_�A�, 1)t1 L, %J J 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).
LA
Signature and Seal License #
STATE OF FLORIDA
COUNTY OF
Sworn to and subscribed, before me this v!�_ day of 20
byWho is pefsonally known tome or who has produced
as identification.
Notary Public, State of FI
Signature of Notary:
Commission Number: S (Seal)
r
En KEGAN CRAWFORD
My COMMISSION # GG265055
EXPIRES October 03, 2022