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Building & Code Regulation Division
2300 Virginia Avenue
COUNTY � Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit # '055(-O
I, l iX. ,C , licensed as a(n)Contractor*/Enginee 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 101 G 1002-0 , 1 did personally inspect the roof deck nailing
(Date)
work at: MOCI '+V('
(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
is most s igent).
Signa re and Seal
STATE OF FLORIDA
COUNTY OF '51- E I
License #
Sworn to and subscribed before me this I`J--4+' day of ECR2— ha- 20ZL
by 00G' f 1 W0 Who is personally known to me or who has produced
1V- as identification.
Notary Public, State of Florida
Signature of Notary:
Commission Number: ��b NEE
NotarytateaFloride
s
n GG 985470En 024