HomeMy WebLinkAboutRoof Inspection Affidavit vgsAsi. T}� �_ Public Works Department
g � . Code Compliance Division
.., i F
2300 Virginia Avenue
: COUNTY
1��5�d313
Fort Pierce, FL 34982
772-462-2172 Fax: 772-462-6443
INSPECTION AFFIDAVIT
RE�E�
Re• Permit# US
I, �' R:�;Jl licensed as a(n)Contra ctor*/Engin ee r/Arch itect
(Please print name&circle license type) *F5468 Building Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under468 F.S.to make such an inspection.
On or about bjcYj G 'z0' , 1 did personally inspect the.roof deck nailing and/or
(Date) (circle those that apply)
secondary water barrier work at:
(Job site address)
Based upon that examination I have determined the installation was done according to the
Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.)
CC.C- C)C-::. es�
i ure and Seal License#
r
STATE OF FLORIDA
COUNTY OF C-��
Sworn to and subscribed before me this day of 20_�5
by-T-by, Who is personally known to me or who has produced
�Lp L as identification.
• OEANNA GIVENS
Notary Public,
StatFlorida � Pue 1,o= public n"state of Flo
da
NoaysXofire Dec 16.201 6
y Comm EE 858761Signatureof Notary M
Commission Number: ���Irc �.�. Through National Nola!
�e al)Gomm
'a"";E OF F�°� 9ot�ded !assn
<;.
En 09/17/09