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Building&Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax:772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# 21-21 " 0�( 2�i7
I, Christopher Collins 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 an inspection.
On or about I did personally inspect the roof deck nailing
(Date)
work at: P FL,
(job site address)
Ba d upon t t e amination I ave determined the installation was done according to the current
ition of Flori a r-
CCC-058011g B ilding Code Section 611 or the product approval submitted (whichever is
most str' nt).
Seal License#
STATE OF FLOIRq U6 iy.
COUNTY OF 5`] �j C }J
Swo tp n subs ibed before me this �D1k day of!'�bW*� 2010
b who is personally known tome or who has produced
<, as identification. —�
Notary Public,State of FI
Signature of Notary:
Commission Number: :s::. Nola Public-5lalsofFIor;da (Seal)
c0=15VIM#GG 1fi9025
M¢,r My Comm,Expires Dec 18,2G21
En 01/19/2011 Bundedlh rough NellonaiNotaryhsn