HomeMy WebLinkAbout2003-0316 Roof Affidavit'A n -l.
Re: Pe rmit # c 6� ""0- �i�
(Please print name & c
T "AA r, r"Iu
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
licensed as a(n)Contractor*/Engineer/Architect
ircle 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 �/ ���°`d��
work at:
(Date)
t did per'iis�����Dn,aily inspect the roof deck nailin
(lob 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 anproval submitted (whichever
is most straigent).
Signatu
STATE OF FLOR
COUNTY OF
M
and Seal
Swor o and subscribed b f
by
Notary Public, State
Signature of Notary,,
Commission Numbe
En
ore me this c;/- da ofIna
.
whois peE
ally kn' �
as identification.
00e
License #
to me or
_ 20MC 0
who has produced
(Seal)
CHARLENE DILLINGER
Notary Public -State of Florida
Commission # GG 956356
My Commission Expires
April 03, 2024