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Re: Permit #
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Planning & Development Serviices
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443 11
ROOF INSPECTION AFFIDAVIT
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I, Vo q Qo.Q , licensed as a(n) ontractor* ngineer/Architect
(Please print name & circle license type) *FS468 Building Inspector
*General, Building, Resi ential or Roofing Contractor or any individual certified under 468 F.S. to makes uch an
On or about 10 7 "�LO , I did personally inspect the roof deck nailing
(Dal )
work at: F(p0q KAkfAtj Nvt Fk- {�►`ml FL
(Job site address)
Based upon that examination I have determined the installation was done according to thl
edition of the Flori a Existing Building Code Section 708 or the product approval submitt
is most strigent). _
ignature and Seal License #
STATE OF FLORIDA
COUNTY OF Z�
Sw rn to and subscribed before me this l day of _ �G706ka- 20-Ze
by 4. Who is personal►v known tome or who has produced
as identification.
Notary Public, State _
Signature of Notary:
Commission Number: (Seall
current
(whichever
20'" ``B� KEGAN RAWF RD
En MY COMMI ION # GG 6M055
��oF�pP EXPIRES)ctober 03. 2022