HomeMy WebLinkAboutRoof Inspection Affidavit 0410512017 13:29 OW) P.0011001
Planning& Development Services
Building&Code Regulation Division
2300 Virginia Avenue
o Fort Pierce, FL 34982
IF L772-462.2165 or 772-462-2172
Fax;772.462-6443
ROOF INSPECTION AFFIDAVIT
Re; Permit# t 401—0 i dL
(l.L
I, LAY0, licensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle license type) *F5468 Building Inspector
*General,Building,Residentiol or Roofing Controctor or any Individual cerd led under 468 F.S.to make Such on In$peCtion.
On or about D( IZ (q . I did personally inspect the roof deck nailing
(Date)
workat• Vigo w mawr,4 yu. &.t- vwz �-
(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 611 or the product approval submitted (whichever is
most strigent).
Signa ure and Seal License#
STATE OF FLORIDA
COUNTY OF i(a t An.
Swora to and subscribed before me this��, day of 2OL+,
by � . Who Is personally known tb me or who has produced
as Identification.
Notary Public,State of
Signature of Notary:
Commission Number: (Seal)
En 02/19/2011
'rJy� MY COMMISSION
9 FF 062929
EXPIRES:October 29,2017
',�, r B.n Ad_M'NDW'F4V.UndenvAlea`