HomeMy WebLinkAboutBuilding Permit (2)Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-21.72
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit # C�
ed as a (n)Contractor*/Engi nee r/Architect
Please print na e & circle license type) *FS468 Building Inspector
*General, Building, Residential or Roofing Contractor or any individual certified under 458 F.S. to make such an inspection.
�� ��� 1 did personally inspect the roof deck nailing
On or about i
(date) % m
work at: 0 1 S lsy I U
(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 approval submitted (whichever
is most strigent).
- /(a
Signature and Seat
License #
STATE OF FL 10 lu1.i ��
COUNTY OF
e
Swo o sc ' d r this --� day of _ 2Q�
by Who is perSn who has produced
as identification.
Notary Public, State o Y'P�u, KATHI RINE HAVENS
!t:Ej��=2°`P `'B`�= MY COMMISSION #GG165030
Signature of Notary = EXPIRES: DEC 04, 2021
Seal E,`'
Commission Number: ( )4, Rnndad through 1st State Insurance
En