HomeMy WebLinkAboutRoof Inspection 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# ')'W- nS 11I)
I,6r"A&nV;11y tm6y/Clicensed as a(n) ntracto */Engineer/Architect
(Please print name&circle license type) *FS468 Building Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about of I I rya J , I did personally inspect the roof deck nailing
(Date)
workat: *'1CI°r GGXtckb"a A LA Po�fS�• .�t.�4r3 t
(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
7Ei;Se;
%ag
License#
STATE OF FLORI A�� ' � " ,
COUNTY OF S •VI•Lrii
Sworn to and subscribed before me this I day of 201
by Who is personally known rn ma or who has produced
as identification.
Notary Public,State of Frpri0
Signature of Notary: W�
Commission Number: Gri J (Seal)
Gina Domedic0
En TS NOTARY PUBLIC
STATE OF FLORIDA
�� : = Comm#GG165138
' qC o° Expires 1214/2021