HomeMy WebLinkAboutRoof Affidavit.pdf.-.
COUNTY'`
F
LORI
D A
Planning & 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#,jDaO -0136
llyejtp-AN , licensed as a(n ontractor /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 on inspection.
On or about 8/Y/yew I did personally inspect the roof deck nailing
(Date)
workat:lSo Xe L?&,,-4A ce..r l �o.l 5nt.l G c«r Icy J✓1PJ
(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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Signature and Seal License #
STATE OF FLORI A r
COUNTY OF.�,A
S rn lo and subseribed before me this 4 day of CN
by Vi OLfkL .. Kk IC QYAn . Who is personally known to kah or who has produced
as idantification.
Notary Public, State of
Signature of Notary:
Commission Number: (Seal)
En
=o"Sy vuerc RHONDALYNNOKSMAN
��� Commission A GG 174772
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