HomeMy WebLinkAboutRoof Affidavit Planning & Development Services
' fj .E 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: Per it#e5;I'l o-j-
S%.
i, 7, ' as vez, 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 certified under 468 F.S.to make such an inspection.
On or aL out�aJ I did personally inspect the roof deck nailing
(Date)/
work at: b / AA Letz k 51
-
(Job site address)
Based u on that examination I have determined the installation was done according to the current
edition f the Florida Existing Building Code Section 708 or the product approval submitted (whichever
is most i ent).
C cc 139
nature and Seal License#
STATE OF LORIDA
COUNTY F A/1-,i,
Sworn to nd subscribed before me this S day of 206V
by T VSqt1,e2- /- Who is personally known to me or who has produced
as identification.
Notary Pu lic,State of Flor' a
Signature Df Notary:
Commission Number: (Seal)
En
• v aye.., JENNIFER LEE COUTINHO
Notary Public-State of Florida
• A`
7rt Commission#GG 362000
o QE` My comm.Expires Aug 4,2023
Bonded through National Notary Assn.