HomeMy WebLinkAboutRoof Inspection Affidavitr
Public Works Department
2. Code Compliance Division
2300 Virginia Avenue
IF L • • Fort Pierce, FL 34982 .
772-462-2172 Fax: 772-462-6443
INSPECTION AFFIDAVIT
Re: Permit# L 0 3— (),j 0 C
l,:Pi ck&2J �p,4 Ut,1.L. , licensed as a(n ntractor*/Engineer/Architect
(Please print name&circle license type) *FS468 Bui g Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about C) I a 9 off.0i I did personally inspect the roof deck nailing and/or
(Date) (circle those that apply)
secondary water barrier work at: '5 e b 2 %ry G 0 O 1. S
(Job site address)
Based upon that examination I have determined the installation was done according to the
Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.)
0-WO-7 aCaC76.273 3,::�
Signature and Seal License#
STATE OF FLORID a
COUNTY OF
Sworn a((��d subscribed efore me this day of 2017
by �i/7ltY�� �Iy ho is personag nown to me or who has produced
as identification.
Notary Public,State of Florida
Signature of Notary:
Commission Number: (Seal)
En 09/17/09
AUDREY B.HUMPHREY
C24 MY COMMISSION#FF 174772
qz EXPIRES:March 6,2019
Bonded Thru Notary Public Underwriters