HomeMy WebLinkAboutRoof insp affPlanning & 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 #ZOD15P C-2)C t
licensed as a(n)Contractor*/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 an inspection.
t f� , I did personally inspect the roof deck nailing
On or about p Y • p
(Date)
work at: I � Eoneb`�fl
(Job site address)
Based upon thit)
71-11
Ll
edition of the ti
is most stri
STATE OF FLORRLDA
COUNTY OF J
and
Notary Public, State of
Signature of Notary:
Commission Nu r: _
En
eal
rmined the installation was done according to the current
de Section 708 or the product approval submitted (whichever
License #
before me this 4T day of ' ` Ft 20
Who is personally knownYo me or who has produced
A A identificatiova _ A
.may a Notary Public State of Florida
ADOLI MIRONCHUK
y , My Commission GG 098831
ort�°o- Expires 04/27/2021
(Seal)
oar 1'1- Notan• - .nlic State of Florida
-ission GG 098831
Osstoa �' ` 4/27/2021