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COUNTY
F L O R I WD A
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pieke, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit #_SLC- ?-0jn -00-+3
1, _ lic<sE�:d as a(n)Contract /Engineer/Architect
(Please ri t name & circle license type) Building Inspector
i
*General, Budding, Residential or Roofing Contractor or any individual certified under 468 F.S. to make s�ch an inspection.
On or aboutr I did personally inspect the roof deck nailing
I at
work at:
I
(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 strigent).
Signature and Seal
'r- t 326
License #
I
STATE OF FLO DA
COUNTY OF
Sworn to and Subscribed before me this (- day of / Q
� Dj kA4j-L�o�
by ^ Qt -, `9, (ZvG-, . Who is personally known to me or who has produced
as identification.
Notary Public, State of r1a
Signature of Notary:
Commission Number: (Seal)
En 01/19/2011
KEGAN CRAWFORD
My COMMISSION # GG265055
EXPIRES October 03, 2022