HomeMy WebLinkAboutRoad Impact Fees Planning & Development Services
Building&Code Regulation Division
® 2300 Virginia Avenue
0 o Fort Pierce, FL 34982
-- -- - 772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
C
Re: Permit# 77(21 DI 16
I, 60mv) �('Jg , licensed as a( Contractor* ,Engineer/Architect
_ _(P_lease print name-&circle-license type)_ _ _ _ _*FS468 Building_lnspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about O 2®� I did personally inspect the roof deck nailing
(Date)
work at:
(Job site address)
Based upon that examination I have determinedFie iiistaifation-was done-acccarding to the current
edition of the Florida Existin Building Code Section 708 or the product approval submitted (whichever
is most igent).
Signature and.Seal License #
STATE OF FLORIDA ,
COUNTY OF S 4. -P-
Sw rn to and sub crib before me this 8(4t day of 20L"
by Who is personally known to me or who has produced
as identification.
Notary PuLNota
te lor' a
aQr 'D� LYNETTE RODRIGUEZ `Signature °a ° Notary Public,State of Florida
Commissiber: (Se
Commission#FF 153635
M
Y comm-ex it' �.,�:�,,"„�,� p es Oct.2 i 4