HomeMy WebLinkAboutRoof Inspection Affidavit i 0
Planning& Development Services
Building&Code Regulation Division
® 2300 Virginia Avenue
g o Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# -76 V l
I, LLL't //,(� j , 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 about f e , I did personally inspect the roof deck nailing
(Date)
work at: � ��� �Sl ti�� � � e-
(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).
(-,-
Signature and Seal License#
STATE OF FLORIDA
COUNTY OF ID k
Sworn to and subscribed before a this IS-
day of 20A-_),
Who is personally known to Ae or who has produced
eAbQQ,,�_ as identification.
Notary PublicAer
Signature of Commission (Seal)
En 01/19/2011
o, YP'Y,, LASHAHNAINGRAM
o`er 8� � Notary Public-state of Floric'a
.r a�a •-
� � My Comm.Expires Dec 20,?. 1
Commission FF 1772•'?
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