HomeMy WebLinkAboutSLC Mann - Affidavit Updated Notary Planning& Development Services
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Building&Cade Regulation Division
,
w 2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#
1, Larry Neese , licensed as a(n)Contractor*/Engineer/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 on inspection.
On or about I did personally inspect the roof deck nailing
(Date)
work at:
(Job site addr
Based upon that examination I have de mined the installation was done according to the current
edition of the F a Ex ting Buil g Code Section 611 or the product approval submitted (whichever is
most stri t).
CCC 1330608
Si ature and Seal License#
STATE OF FLORIDA k '
COUNTY C Sf--
Sworn to and subscribed before me this day of 20_,
by Larev Who is personally known to me or who has produced
as identification.
Notary Public,State of Florida kel
Signature of Notary:_ (kw / /.ql��/
Notary Pubic State of Florida
Commission Number. a'411-r4 (9"9N Wood
My Commission GG 241645
En 01/19/2011 vap
gExpires 07/25/2022