HomeMy WebLinkAboutRoof AffidavitPla nni ng & Development Se.ry i ces
Ru i Idi rig & Code Rep I ation Div i sic n
Xf 2300 Virg nix Avenue
COUNTY F ort Pi a rce, F L 34992
772-462-22 6 5 or 772-462-2172
Fax: 772-462- 3
ROOF I NSP ECT ION AF F IDAVIT
Re; Perrnit 40 2101-0250
FRCLAN D WI LE Y , I icen 5-ed as M C-ontractor* rein ee rf Arc#iitect
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Q n o r a bout 1-21-2021 , a d id pe rson aI I}r w speck the roof deck n a i I ir«
I Date)
work at:
3401 Coftez Blvd
(lob site addfess)
Based upon th at ex;mmin a don I have determ ined the ifwallati o n was dorre arx-ording to th-a eu rrent
edition of t he IN oridb Ex ist irig Bul I dire g Code Section 708 or th a prod uct a pproval Su bmitted I whic hexer
is oSC �Crigentj.
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Signature and Seal
STATE OF FLQRI
COUNTY DF
L icen r,e H
R �rtd s rltYe+d before me th iday of
by —. who is Si FiC trsoanallyr known w me or who -has jprodvwd
as iden i4t m.
Mata ryr 4>ublic, State of Flvri€ia
Signature of Notary: e," � BRANDYO 1C2931
CDmm i s s i o n N umtr, ComRlp
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�- EROM Mayl.2021
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