HomeMy WebLinkAboutRoof AffidavitNLM 4,104
Planning & Development Services
Building & Code Regulation Division
ICOUNTY 2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit # :5L(, - 2,QO - ,4
I, __ ' , licensed-atn)Contractor* ngineer/Architect
(Please p nt name & circle license type) -Building Inspector
*General, Building, Residential or Roofing Contractor or any individual certified under 468 F.S. to make such on inspection.
On or about 10 ?,OL�, I did personally inspect the roof deck nailing
(bate
work at: &7taCr Plrrce -
(Job site addre )
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 strigent).
0" '�- P'W
Signature and Seal
CCC 132 b 534. _
License #
STATE OF FLORIDA
COUNTY OF A —VT -IV
Sworn to and subscribed before me this day of 2a,
by DV non& �vt� iti VI(ho is personally known to me or who has produced
>o
as identification.
Notary Public.State of
Signature of Notary:
Commission Number: (Seal)
R2E9
FORDEn 01/19/2011 GG26505503. 2022