HomeMy WebLinkAboutmedici affPlanning & 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
Re: Permit #_x�.} 6' .
I, i A' sed 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 on inspection.
On or about �" 2-o I did personally inspect the roof deck nailing
(Date)
-,
work at: A
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of t to ida Existing Building Code Section 708 or the product approval submitted (whichever
is most�strijze�
Signature and Seal
C 0 '(-R a�
License #
STATE OF FLO FQ
COUNTY OFA..
Sn W and subscribed before me his day of _ 20
by J 1 [ C4 RC1 �4.ti 1, it t 1 . Who is personally known to me or who has produced
as identification.
Notary Public, State of iarida
Signature of Notary: I fS-.
Commission Number: S (Seal)
En
r_04j-q" pn
Notary PubEic State of Florida
";marlda P Sanderson
Lt:rrnmission GG 211256
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