HomeMy WebLinkAboutRoof Affidavit i
Planning & Develop ent Servwices
Building & Code Regulation D 'Ivislon
� 2300 Virginia Avenue
Fort Piece , FL 34982
772-m-4624- 2165 or 772462 = 2172
Fix : 772 -452- 6443
ROOF INSPECTION AFFIDAVIT
Re : Permit #
Christo er Collins . licensed as a ( n ) Contractor * /Engineer/Architect
Please print name & circle license type ) * F5468 Building Inspector
* Gene ral, Building, Residen U"al or Roofin g Con tractor or any individu a I rertlfled un der 468 F,, S- to m ake such an In spec tion.
On or about � � f � �C� I did personally inspect the roof deck nailing
( oat )
work at : ox� �
(Job s1te address )
a U h t examine " n I have determined the installation was done according to the current
it1*0 of the orid a Exi stin Building Cade Section 611 or th e product approval su bmitted { whichever is
mo stri
ccc.-M058011
Signa re and Seal License #
STATE or FLORIDA
CO U N TY O F �' ' I ,A-� [L �
Sworn to and subscribed before me this [ day of 2Q�
by C . Who is personally kno w n t e or who has produced
-�4 - %00C;F 1, &Vas identification.
Notary Public, State of Florida
Signature of Notary :
Commission Number: Rebekah Hov
%mrr" NOTARY PUBuG
� STAGE OF FLORIUA
En O1� 14�2011 ' ' ' ' ? Corn GG2 W 10
Exp I re a 21 1712023
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