HomeMy WebLinkAboutRoof AffidavitPlanning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
d-
772-462-2165 or 772-462-2172
Fax:772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#C-gCc)Q,• Qn-+
I �YlVldtl%Cgicensed 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 an inspection.
On or about N-k3(Z)10tkj I did personally inspect the roof deck nailing
(Date)
work at: iOkbl CS MSCLa r\\iC', 4)aG.
(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)
Signature an Se I License #
STATE OF FL I�
STATE
COUN
Swor to and subscribed before me this da 2
by Who l�`[1�130'�� ,. Who i�p sonally known to me or he,has produced
as identificaT
Notary Public, St e o Flor'
Signature of Notry:
Commission Num er? (Seal)
En r ^'"'!}a;. 440VNMgMEGRON6
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EXPIRES: 19, 2M
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