HomeMy WebLinkAbout4701 AffidavitPlanning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce,tL34982
77 2-462-2165 or 7 7 2-462-2L7 2
Fax:772-462-6441
ROOF INSPECTION AFFIDAVIT
Re: Permit #.5\-( amf * Oa'\D
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(Please print name & circle license type) *FS468 Building lnspector
* General, Building, Residentiol or Roofing Controctor or any individuol certified under 468 F.S. to moke such on inspection.
On or about ()I did personally inspect the roof deck nailine
(Date)
work at:Dr. Fovt PiLYu FL q82
(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).
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Signatu rea Seal License #
STATE OF FLORIDA
COUNTY OF .St U\JC,J&
Sworn to and subscribed before me this l5s ouyot a\zo'Llo,
by Who is personally known to me or who has produced
Notary Public, State of Florida
Signature of Notary:
Commission Number:
Ruth Eunice Cardero
NOTARYPUBLIC
ATE OF FLORIDA
Cornr# GG930957
Expires 1111212023En
(Seal)
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