HomeMy WebLinkAboutRoof Affidavit Planning& Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# —70 7 C?5 3 Z
I, , licensed as a( ontractor* Engineer/Architect
(Please print na &circle license type) *F 68 spector
*General,Building,Residential or Roofi g Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about 0 ?� , I did personally inspect the roof deck nailing
(D e)
work at: � —
(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).
Signs ure and Seal License#
STATE OF FLORIDA
COUNTY OF
Sworn to and subscribed before me this ev• day of 20
by T�)q— Who is person Fjfknown tome or who has produced
// as identification.
Notary Public,State of Florida
Signature of Notary:
ommission Number: S
C ( )
En 01/19/2011
AUCREY B.HUMPHREY
MY COM%IISSION#FF 174772
EXPIRES:March 6,2019
Public Undarv+rilers
I •;e' �yq,• Bonded Peru Nota y