HomeMy WebLinkAboutRoof Inspection AffidavitPlanning & 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 #
I,,lised as a(n)Contractor*/Engineer/Architect
flase 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 7(( I did personally inspect the roof deck nailing
(Dat' )
work at: bl 161&Emm Tq —�-/��rr
(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 stri ent).
l
Signature and Seal
STATE OF FLO
!!�
COUNTY OF
CCU' C2
License #
Suu®rm o�d�scri e b re met is day of , i` ; ` 20 eG
by A' Who is personally known me or who has produced
as identification.
Notary Public, Stat
Signature of Nota
Commission Number:
2ot:::ISERINE HAVENS
En ISSIDN #GG165030
9: DEC 04, 2021
ugh 1st State Insurance