HomeMy WebLinkAboutRoof AffidavitI
Re.Perm:lt#.o'W .()�—{�-Mul
Planning Develop ent Services
Building Code Regulation Di9vision
2300 Virginia Avenue
Fort Pierce, FL 34982
772m462-216!i or 772=462.2172
Fax: 772.462.6443
ROOF INSPECTION AFFIDAVIT
� licensed as a
(n)Contractor*/En2inep-r/Arrhitprt
(Please print name & circle license type)
* General, Buildin
On or about
g� Resident'ia1 or Roofing Contract
1
{
work at: �lt
r
—F —
Date)
FS468 Building Inspector
or or any indivrdual certified under 468 F.S. to make such an inspection.
did personally inspect the roof deck Wallin
VN' (7v
(Job site addr
Based upon that examination I have determined the insta
edition of the Florida Existing Bu
is most strigent)&
Signa
e and Seal
STATE OF FLORIDA
COUNTY OF { �vl�\
Sworn to and subscribed before me
by 7�jv N
Notary Public, State of Rorirr;4
Signature of Notary:,,.-,
Commission Number:
Erg
ildin,91 Code Section 7�08 o
•
11ation was done according to the current
r the product approval submitted (whichever
License #
this �_ day of 24 !' ,
_. Who is personally known to me or rho has produced
_ as identification.
(Seal)
`x� -00 MVANNA NEGRON B
�1 r i• do Ire
* + COWVSWN GG 323420
4WY
* M
dip
f y ORES. AV$VIP 0
23
fi *;