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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# 21()2, 03'5 -
I, 1,71LFIfd�V1 licensed as a(n)Contractor*/Enginee r/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 31'2312; , 1 did personally inspect the roof deck nailing
( Date)
work at: I O3 t.jg {-c eitx7d C 4--" 3- qE3 '7-
(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).
Signature and Seal
STATE OF FLORIDA =
COUNTY OF 54—
License #
Sworn to and subscri d before me this 2 J day of M c)'V -h _ 20 ZI
by Who is personally known to me or who has produced
as identification.
Notary Public, State of
Signature of Notary:_
Commission Number:
En
Notary Public State of Florida
R@pglp Jones
My Commission GG 985470
Expires 00115/2024