HomeMy WebLinkAboutRoof Inspection Affidavit QX Planning& Development Services
H—PI ` Building&Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2
Fax:772-462-6443
RECEIVED
ROOF INSPECTION AFFIDAVIT i NOY 12017
r
itti;ng Depai'tlf>t>;ent
Re: Permit# — i; Lul de County, FL
licensed as a(n)Contractor*/Engineer/Architect
(Please prin ame&circle license type) *FS468 Building Inspector
I
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F S..to make such Ian inspection.
On or about 1) )
I did personally inspect the roof deck nailin�g
(Date) I i
work at: �a Ayc-
(Job site address)
i
i
Based upon that examination I have determined the installation was done according to the current
edition o e Florida Existing Building Code Section 611 or the product approval
Isubmitted (whichever is
- most rig nt).�.
�
on
Cam. i
ignature and Seal License
1
STATE OF FLORI•/j
COUNTY OF S U u--31
• i
Sworn to and subscribed before me this t day of l A6\1 201�
by, P-Itx�cr Who is personally known to me or who has produced
as identific ti j
Notary Public,Sllate of Florida. BI90i }
Signature of Not
B i w COmAtitsl0nf�3611'JZ9i
Commission Number (Seal) Eq*o Jum 16,20V
?�fld�° eadeenn+a�ege�rto,er�twrtoM
En 01/19/2011
i
j
1
I
I.
�1
i