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"` 4 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 # 2101-0578
l� Christopher Collins , licensed as a(n)Contractor*/Engineer/Architect
(Please print name & circle license type) *FS468 Building Inspector
*General, Building, Residential or Roofing Contractor or any individual certiped under 468 F.S. to make such an inspection.
On or about 02/15/2021 , 1 did personally inspect the roof deck nailing
(Date)
work at: 5712 Raintree TO., Ft Pierce FL (Back Building)
is most
(job site address)
pon that m nation I have jetermined the installation was done according to the current
of theyforida Yxisting Buildind Code Section 708 or the product approval submitted (whichever
re an
CCC-058011
License #
STATE OF FLORIDA � f �,' ` n
COUNTY OF l�(6Z
Sworn tq d ubscri ed before me this .
day of 2Q
by (�1yF� 1 Who is personally known to melor who has produced
as identifica o� .
Notary Public, State of Florida M - -
Signature of Notary:
Commission Number. : `:* •'' tMU"a (Seal)
`, • CummlF,icn M GG to
En t M hl Nmt�om�Nag,1
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