HomeMy WebLinkAboutRoof Inspection Affidavit Planning & Development Services
7�; r € E7,
ry-- 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#R (D-Z SY
l,, 1 do 0-vI,►n0V%-Hcensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle license type) *FS468 Building Inspector
*General,Building,Residential or Roofing Contractor or any individual certlfled under 468F.S. to make such an Inspection.
On or about_mil /S 1 , I did personally inspect the roof deck nailing
(Date)
work
G- 1
at: �c �
(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),
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Y
SSign�ature and Seal License#
STATE OF FLORID _
COUNTY OF V1 '
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Sworn to and subs ribed before me this day of 20
by-jZhn �hTcz:::�,. Who is personally known to me or who has . stataF<<E
as identification. '�9°F�°�� COmry,sF1O`aa
n,n jy C Si°� Nota (V
Notary Public,State of Florida. FX op 9'C
Signature of Notary:-
Commission Number: (Seal)
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