HomeMy WebLinkAboutRoof Affidavitc6ouL' NTS' .
F L O R I 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 #SLC Z010 '0�c( I
IRobert Donovan licensed as a(n)ontracto /Engineer/Architect
(Please print name & circle license type) *FS468 Building Inspector
*General, Building, Residential or Roofing Contractor or any individual certified under 468 F5. to make such an inspection.
j !'1
On or about l� I did personally inspect the roof deck nailin
(Date)
work at:
(Joie lite address)
current
Based upon that examination I have determined the installation dapp cigal t submitted (whichever
edition of the Florida Existing Building Code Section 708 or the
product
is most strigent)-
Signa u and Seal
CCC1330489
License #
STATE OF FLORIDA Palm Beach 20
Ilht�'2d
COUNTY OF =
—LQ—day of produced
Sworn to and subscribed before rye who is personally knowjtmeorwho has p
by Robert Donovan as identification.
Notary Public, State of Florida (Seal)
Signature of Notary: GG 9 0883
Commission Number:
CHRISTAIYN Sp,Lh10NSON
y; DIY COMMISSION 1i GG 930883
En., EXPIRES: March 10, 2024
y�Po� ►��p Bonded TMl Notary Pubttc Underwriters
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