HomeMy WebLinkAboutSLC.2010.0356 ROOF INSP AFFIDAVITPlanning & Development Services
_ = Building & Code Regulation Division
2300 Virginia Avenue
* o Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit #_S L4 - e�X 8/0 -O 3 ST
1 ' lee 9"'4-st, licensed as a(n) ontracto /€ngineer/Architect
(Please print narne & 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 I did personally inspect the roof deck nailing
(Date)
work at: ti94 ?
(Job site address)
Based upon that examination 1 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 m rigent).
6 �: 0 e- 133 -2 t/4(4f
Signature and Seal License #
STATE OF FLORIDA
COUNTY OF.
Sworn to and sub crib d before me this ��°� day of At%)gz12-, 20,;�p
b Who is personaily known to me or who has produced
��.
' as identification.
Notary Public, Sta a
Signature of Notar
Commission Number: (Seal) �Q�RSq(�°ri
�N co Q
En
Q' My Comm_ Expires _ =
July 13,202
No. GG 124151 0 4
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