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Fort Piero cL 3A082
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ROOF INSPECTION AFFIDAVIT
He: Permit # to �I 0 — os
\
I, c o 1 �()Us S , licensed as a( Contr /Engineer/Architect
(Please print name & circle license type) *FS468 Building Inspector
*General, Building, Residential or Roofing Contractor or any individual certified under 46S F.S. to make such an inspection.
On or about °Z0 a `f did personally inspect the roof deck nailing
(Date]
work at: COLI05 �)&(\ S ) C - r-at PI fLC �l l C.�c
(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 611 or the product approval submitted (whichever is
mosisirig /.
'Signature and Seal
CCC_— c 330-41.
License #
STATE OF FLORIDA
COUNTY OF
Sworn tot\1 nd subscrjped before me this day of A S 20.
by—s )Cklr\V15j Who is personally known to a or who has produced
—a �
as identification.
Notary Public, State of Florida
Signature of Notary:
_
Commiswn Number_
(Seal)
En 01/19/2011
�v ' Notary Pubko State of Fbrga
iS Kelsi Moss
My Commnswn GO 308996
eta w Expres 03/07/2023