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= M•�,.� 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# X8-C*44
I, licensed as a(n)Contractor*/Engi nee r/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 q l?—f I did personally inspect the roof deck nailing
(Date) yam"
work at: LP Lo I z ,�t rl aoL
(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 708 or the product approval submitted (whichever
i os trigent Si ature nd Seal License#
STATE OF FLORIDA
COUNTY OFC/ e _
rc.(
Swor ,to and subscribed before me this 2:3 day of��� 20 Zr�
by Who is personally known to me or who has produced
as identification.
Notary Public,State of FloridaC"
Rig
teofFWft
Signature of Notary: �, GG 985470
Commission Number: U 24En