HomeMy WebLinkAboutRoof inspection affPlanning & Development Services
eta 4 Building & Code Regulation Division
OUN
2300 V'I'rginia Ave nue
� R ID Fart Pierce,, FL 34982
F L A Nampo"
772462va2l65 or 772m462-2172
Fax: 772w462w6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# 1,lops-
Christopher Collins _ ,Incensed as a(n)Contractor*/Enineer/Architectg
(Please print name & circle license type) 'IF5458 Building Inspector
* Geri eraf, Building, R es iden Vo I or Roofin q Con tractor or any ind(Vidual certf-edt+nder 4f.S, to make s urh an inspec Non,
On or about _ �C ] 1 � h 1 2(3 OZ I did personally inspect the roof deck nai i-n
(Date)
work at•� �-�� L kL.JL., �—
�� (job site address)
ed up::he
n at eurination I ave determined the installation was done according to the cu rre nt
edition lori)a Existing B Iding Code Section 611 or the product approval submitted {whichever is
most ri
�► CCC-058011
Si na e and Sea! License #
STATE OF FLORIDA
f
COUNTY OF L2r f ia
Sworn to and subscribed before me this dad of .0�
by - 4 ho is personally kno n to me or who has prod uced
- A
as ��entificatron.
Notary Public., State of Flor 0
-W
Signature of Notary.- z-2 1,15 "P
Commission Number: M M J00mur
(Seal)
-4;r�r Lor I F LAMP
En 01/19/2011 R abdQih Hoy
NOTARY PJJBLIC
STATr OF FLORIDA
T COM w-T w- GG2W 10
Expira 2/1712023
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