HomeMy WebLinkAboutRoof Inspection Affidavit 4511712017 15:54 • �� P.0011001
_ Planning&Development Services
� .. Building&Code Regulation Division
2300 Virginia Avenue
o Fort Pierce, Fl.34982
772-462.2165 or 772.462-2172
Fax:772-462.6443
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ROOF INSPECTION AFFIDAVIT
qrl�
Re: Permit4 lt,�-0(70
I, 1.4 licensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle license type) *FS468 Building Inspector
*General Building Residential or Roofing Contractor or Orly individual certified under 468 F.S.to make such an Inspecrlan.
On or about 10 b W/? ,I did personally inspect the roof deck nallina
(Date)
work at: , ®!3 007c hRc,
(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).
Sig License#
STATE OF FLORI DA
COUNTY OF ind&- n
sworn to and subscribed before me this ( I day of fvmW2oj.!�,
by_0?- Lole''` Ine or who has produced
as Identification.
Notary Public,State of Florid
Signature of Notary:
Commission Number: (Seal)
En01/19/2011 "ty� THERESADERITA
MY COMMISSION#FF 06MR
' EXPIRES:Octabat2D.2017
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