HomeMy WebLinkAboutRoof Affidavit i
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 �—�
I,,:V3k . (20.\.v\k ;-kcensed 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 under468 F.S.to make such an inspection.
�I
On or about n l.� 1 �� I did personally inspect the roof deck nailing
( ate)
work at:. Ck r-T-L,r a
(Job site address)
I ,
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
s m trigent).
Signature and Seal License#
STATE OF FLORIDA� I
COUNTY OF C� t,
Sworn top[jq subscob e this day of ID 20J
by . Who is personally known to Ime or who has produced
as identification.
I'
Notary Public,State of Florid
Signature of Notary:
Commission Number: (Seal)
En .otMPoe,
_state of pi
V rida-
gUGHN II
._ o
Commission # °tary Public 9'
Oetobe ssion Expires
22 2022 "
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