HomeMy WebLinkAboutRoof Inspection Affidavit Planning & Developoknt Services
S' Building & Code Regulation Division
2300 Virginia Avenue
o Fort Pierce, FL 34982
~---� - — 772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#
I, J�P-R(t 4 M licensed as a n)Contractor /Engineer/Architect
(Please print ame &circle license type) *FS Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about L—j i^ 1- , 1 did personally inspect the roof deck nailing
(Date)
work at:
(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 611 or the product approval submitted (whichever is
most strigent).
CCC 133 o g 110
Si a u e and Seal License#
STATE OF FLORIDA
COUNTY OF S�
Sworn to and subscribed before me this 09 day of 20 I
byje�re!-1 Who is personally known to me or who has produced
as identification
Notary Public,State of Florida In��� , A , '
Signature of Notary: C��`''�`� r V W�`N
Commission Number: F'F 1 Le o S 19 (Seal)
En 01/19/2011 C®NISTANCE PROULX
f-FMY COMMISSION#FF 160517
ill'il.61, EXPIRES September 16,2018
(407)398-0153 FbrdallotaryService.com