HomeMy WebLinkAboutRoof AffidavitPlanning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce,FL34982
7 7 2-462-2L65 or 7 7 2-462-2L7 2
Fax:772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit #- 0t
r, M.f,yt\n &ntuS , licensed as a(nlContractor*/Engineer/Architect
(Please print name & circle license type) *FS468 Building lnspector
*Generol, Buitding, Residentiol or Roofing Contractor or ony individuol certified under 468 F.S. to make such on inspection.
on or about 01"2"1 2A2O I did personally inspect the roof deck nailine
(Date)
workat: t\t w Air:ltct St. Pnvr St iirr rl ,\ttr-5*1AS'L
(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).
U-L i33\to\D
Signatu re and Seal License #
Sworn to and
by
before me tnis 2$fr oay or .j'., I 14
known to rhe or whoWho is personally
as identification.
20'LA,
has produced
Notary Public, State of
Signature of
commission Number:'gCqSDqSi-
"#il,.t&a{r*
En
(Sea l)
Ruth Eunice Cardero
NOTARYPUBLIC
STATE OF FLORIDA
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Expires 11t12tZAZg
STATE OF FLORIDA
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