HomeMy WebLinkAboutRoof Inspection Affidavit NotarizedPlanning & 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 #,`
1, iDnnitmi '.qimmnns; , licensed as a( Contractor /Engineer/Architect
(Please print name & circle license type) *1=S468 Building Inspector
*General, Building, Residential or Roofing Contractor or any individual certified under 468 F.S. to make such an inspection.
On or about , l did personally inspect the roof deck nailing
(Date)
work at: 2740 Iroquois Ave Fort Pierce, FL 34946
(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
most rigent)
Signature and Seal
STATE OF FLORJ DA • U
COUNTY OF Ir
RC0052013
License #
Sworn to and subs ed before me this day of 20
by�Who is personally known to me or who has produced
r> as identification.
Notary Public, State ofFlorida)
Signature of Notary: _ ,1� }
Commission Number: (Seal)
En 01/19/2011
�ypv auk KAREN D }}pRNER
My COMMISSION # GG OW73
EXPIRE&February24,2021
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