HomeMy WebLinkAboutRoof Inspection Affidavit Mar 1717 07:31 p Seaside Roofing, lnr: 772-283-9421 P.
Planning& Development Services
Division
too.. WVY
0uilding&Code Regulation ®� s,N
7� h2300 Virginia Avenue
w r.,�9 q° Sy
Fort Pierce, F8.34982
772-462-2165 or 772-462-2172
Fax:772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# SLC :�03 (319 �I
1, 3 , 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 WC-0 I did personally inspect the roof deck nailing;
(Date)
work at: 103(p NEMZ5 F3LVIb
(Job site address)
Based upon that examinatio I have determined the installation was done according to the current
edition of the Florida Existi g B ing Code Section 611 or the product approval submitted (whichever is
mos stir en .
Signature and 5 License#
STATE OF FLORIDA NV
� p�
COUNTY OF d d�fAR' tI
Sworn to and subscribed before me this_ day of - - 20/21
by Who is personally known to me or who has produced
as identification.
Notary Public,State of Flori -1
Signature of Notary:
Commission Number: (Seal)
�Q1�`p pU Notary Public State of Florida
En 01/19/2011 - Gregory I:Noll
5, � MY ComMI-Ion FF S61742 Q�1
op Exliirem 01/19/2020
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