HomeMy WebLinkAboutInspection Affidavitw
Public Works Department
Code Compliance Division
2300 'Virginia Avenue
Ft. Pierce, FL 34982-5652
INSPECTION AFFIDA'V'IT
RE: I'er`init # • C/3
I j ,licensed as a( Contra /Engineer/Architect/
(Please print name and circle license type) FS 68 Building Inspector*
General, 'Building, Residential, or Roofing Contractor or any individual certified under 468 F.S. to make such an
inspection. All affidavits must include photographs of each plane of the roof with the permit # or address # clearly
shown marked on the deck for each inspection.
l n
On or about S' %/� 7 _, I did personally inspect the roof
(Date &time)
deck naili and/or econdar water barrie work aty
(circ/le�o» (Job Site Address)
Based upon that examination I have determined the installation was done according to the
Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.)
'Gc S ga- i
re & Seal License #
STATE OF FLORIDA `
COUNTY OF RECEIVED
Sworn to and subscribed before me this day of •200 MAY 12 2009
Who is person known or who has produce,ubto
orks
unty, FL
as identification. '
Notary Publi
Signature of
Commission
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05'vI ME5 4 1T 1
MY OOMMISSION # p0 2010
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cm19/27/07