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HomeMy WebLinkAboutRoof Inspection Affidavit 5 Plan iingl&<DeVbId icnent Service's i r Buttcing--or tion,DIvision . ,� 23(}U�V�rginia llvenue? . - a � �: FortrP�erce,FE'.3498x _ 'ftj ,&2,z,2:1554r,`7.7V462:2172 Fax:7f7:2t 62°64'43 R00-F-[NSPfC1'10'N AIFF.fI)MAt Age l Permit (,?aN�++r fir/ r7'ta (�cer�sed as��(n�CgritractoY 6ng heerjArchltect .(:Please print nape.&clrclE Ilcense type; 1 *FS468'Etuilding�inspectQr"= ,,General;;,tii'ii(du1�p?Aesdentrot or Rgojrpg Con�raccorarany rri�iuiifun�rert�e'd,undern�58 f,S.famake,sucla'bn Insj�ectlon� n vrabautpersot7ally inspect the roof deck nat►trr x a(DatP� 7..{' ( Cl ;t1!6 (JoGsiteavaaddress)� } Based upon thatrcxamnation l havc detcrmmedwthe mstallatlon was done according towthe ct�r`r4ent etlition:of"the.F.lorcCa Eki"sfir�g B`uilcItng,Code-Seetiran.7..OS Qr the,{roduct app¢ova!sub netted(whichever: 'is r>oststrgent:., s Sep �Icense#, STATE 4F FLO�RIDAz f ,rY�5 orn Sw a arici`su}�scribed beforetime thy;„ sday of�//�tEA�QE+4 20oZ0 5 by;�EfX r/E',��'d4f.��{:• Wtiozfs personally krr�w�tv,me.or w`hQ��,as_produced' ideil'tjfrcattolz: a Nta(�rPciblj��Statax,f F1n �a s .r�r ddtFYpuWwSrareotFroynda Cr•tmlsSi 5lgnature of Ndtary �', tan A Snow ���, � z � Mjr Gort NN 012858r � ' Cotnmrssron_Numhe�;, K.4 QJa(,1'� _�_,_". ._�_.._ - - (Spat); � �or�d� E.�res»t✓2�t20a� ,r n