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- Building & Code Regulation Division
i 2390 Virginia Avenue
• .. Fort Pierce, FL 34982
772-462-2165 or 772--462-2172
Fax; 772-462--6443
ROOF INSPECTION AFFIDAVIT
Re: Permit # 126 Q
!, Mark Detlof licensed as a(n)Contractor*/Engineer/Architect
(Please Print name & circle license type) *FS468 Building Inspector
*General, Building, Residential or Roofing Cantraetor or any individual certified under 458 F.S, to rnal a such an inspection.
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Zoto
On or aboutJ)ec el zt, I did personally inspect the roof deck nailing
(Date)
work at: 1:2 �1 C
(Job site address)
-51Y-76-r-37-
Based upon that examination I have determined the installation was done according to the current
edition of strionr� _y the Florida Existing Buildin
i5 most ctC ctiQn 708 or the product approval submitted (whichever
Signature and Seal
STATE OF FLORIDA
COUNTY OF St ! ucle
CCC-1332142
License #
Sworn to and subscribed before me this � day of �t7
by. Mark>�etlot Who is personally known to me or who has produced
;dentife on,
Notary Public, State of Fi 'da � RYA'•• C f IVDY W egg
Signature of NatarY: a° � Norary Public -State of Florida
Commission Ivuraztier: CG 3 #23a,6Commission # GG 312394
(5eal) =..Fok-��a.` MY Commission
'•m,;,.`� May 2223 plies
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