HomeMy WebLinkAboutJamesKurbeicPlanning & Development Services
Building & Code Regulation Division
41 2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit # G L-(- rR 1" 0�A'3
I,'B —g k : ,Wh Luw' licensed as a (n)Contractor*/Engi nee r/Arch itect
(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 J r,1 1-71 '\o-�o . I did personally inspect the roof deck nailing
(Date)
work at: �d2717 �14- iV&A aLe kK-� 55 �1--
(1ob 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 708 or the product approval submitted (which(
is
CILC 0'
and Seal License #
STATE OF FLORIDAp
COUNTY OF
Swc to and subscribed before me this day of D20 Y IbW 200�
by COX. na V Wilee o 's? who is personally _known to me or who has produced
as identification.
Notary Public, State of FI r'da
Signature of Notary: t y Gina Delmedico
Commission Number: �71058 NOTARY PUBLIC
a+STATE OF FLORIDA
En " _ Comm# GG165138
Expires 12/4/2021