HomeMy WebLinkAboutRoof Inspection Affidavit - Permit # 2012-0445Planning & Development services
- _ J ' _ _ Bui I ding & Code R egLil atio n Divi�io n
23 Virginia Avenua
0 -Fort Pierce, F L 34982
772-462-226 5 or 772-462-217 2
Fax: 772-462-6"3
ROOF IT45PECTION AFFIDAVIT
Re; Perm It * 2012-0445
POLAND WILEY , lice rr as n gi neer/Architect
(Plea se print -Iarne & circle I icenw type *f54 EE Build ing inspector
*6emraC BogdM. Resederrt)a� 12.r Romp CoRtmcMr pr pr)V M&Yiduae re.rI eed under 468.r.5. w make surb oR jrrsoec[ion•
On Or about 12-21-2020 1 di d personally i nspect th a roof d u+ k nipan
(C� —
work at; 373 European Lane
jJa 1� bite addressi
aa,5ed u porn t hat exa m I nation I have iJete rmr ned th e i nsta Ilation was done ac-cord iog to t lie c urrent
ed ition of the Florid a Exi s i rig 13uild i no Cod-eSectIDn 708 or the p rodu ct ap proval -5 u b m itted (wh icheve r
ost strige rn). e ;as.
k A..O U IQ 144
Signature a nd 5ea I
5TATE Of FL
COUNTY OF MJI.A-Ic�l
CCC1331170
License #
5 t0 Ind 5ulo Iced, before me t s + -dayr of �
Who is pems ni)lly kelown to me or wha has produced
as Identlficatmn.
Notary Puhlk, State of FIo
5igh:vkufit -of N-0karx- cL.'A_ — er +ulor
Cam mission Number: � ' owmi acn s GO 102 V
rt FiRk*s " 9.2021
Fn po-1-6*0""bra