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Planning & Development Services
- UCA-E" Building& Code Regulation Division
2300 Virginia Avenue
L Fort Pierce, FL 34982
772-462-2165 or 772462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#.�O)2-- p3�'9
I, as a(n)Contractor*/Engineer rchitect
(Please print name&circle license type) *FS l ding Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about`RWI , ( :2172A I did personally inspect the roof deck nailing
(Date)
work at:3 o RoseLA\(\iAl 31 V
(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 708 or the product approval submitted (whichever
is most strigent).
P'eie-1-14 I rl-le— a
5 �
,
Sig License#ture and Se
STATE OF FLORIDA.
COUNTY OF "l�
Sworn to and subscribed before me this 7/� da ofL 20�
by r BAN is personally k o to me or who has produced
identification,
Notary Public,State of F rida
Signature of Notary: -�
Commission Number: ( 23 (Seal)
00 ky� Notary Public State of Florida f' -j' .1 i
' Javier Sarits" l' , o C)
y Y My Commissio�GG 239744 ts, p� p
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$��a1E' Expires07Ht3/2022 ® �
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