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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 # "-Z W P — o C/ Iep 6
CV6r)u M 1�•e"!nsed 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.
On or about/Z7 I� l did personally inspect the roof deck nailing
(Date)
work at:
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).
Signature and Seal
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License #
STATE OF FL I A
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COUNTY OF '}� d`=
Sw rn to and subscribed before m this 4 ` day of I7 20
b41 C . Who is personally known t e or who has produced
as identification.
Notary Public, State o rida
Signature of Notary:
Commission Number: c (Seal)
En
00 a Notary Public State of Florida
r° knanda P Sanderson
My C;LMMISSion GG 211256
` Expires g412512O22
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