HomeMy WebLinkAboutRoof Inspection AffidavitJul, 19. 2017 8:45AM
Ca`1_1,al Roofing PSL
No, 0725• P. 1
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M
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982.
M-462-2165 or 772.462-2172
Fax:172-462-6M
ROOF INSPEMON AFFIDAVIT
Re: Permit #
I, licensed as a( Contractor* ngineerJArchitect
(Please -print -name &-circle license type).. - - -- *Ft468-Bni - ing Inspector
*Geaerat Suildin& Residential orRoofrng co ntractor-orohy individual eenred ander46$ F.S. to make such an lnspecdam
On or abut I I did 'personally inspect the roof deck nallina
work at:
(Job site address)
Based up on that examination I have determined the installation was done according to the current
edition • Florlda lWstigg Building Code Section •621 or the product approval submitted (whichever is'
License #
f
STATE Dl: IaLOIZID�
CourVTy 4
Swornt ndsubscribedbefo me this aL 20j
by 1 D �. Who i ono own to me who has produced
as Identification:
Notary Public,'State of Florida
Signature Of Notary-
Commission Number: 3 (Seal)
En 01Aq/2oli
g Nomq FW* Su to of Flex a
KM18 J Simone
My cammiwion FF 981331
as E*rs205/1t►=0
RECEIVED JUL 19.1017