HomeMy WebLinkAboutRoof Inspection Affidavit , - Planning& Development Services
Building& Code Regulation Division
2300 Virginia Avenue
COUNTY w Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# 2p l 2-- M J C>
I, ZC�-DkUOI 5C" 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 �2 l� I did personally inspect the roof deck nailing
(Date)work at:3 2 Z I ► )Ll�
(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 708 or the product approval submitted (whichever
is most strig
Signature and Seal License#
STATE OF FLOf3GD�1 f
COUNTY OF `�l�l_.
Sworn to and subscribed before me this t day of 20�W
by J-rz Who is personally known to me or who has produced
q/ -Js ide tification.
I
Notary Public,State of Florida f�
Signature of Notary:
Commission Numb/ (, ('Seal)
En
roar°K Notary Public State of FlorWaa
ADOLI MIRONCHUK
y �oaAc Exp 0 098831
ires /27/.�.02
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