HomeMy WebLinkAboutRoof Inspection Affidavit10127120/7 15:12 LUVIANO ROOFING _ TAMP 357 3566 P.0031004
COUNTY
IFL Q R l D A,
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462.2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
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Re: Permitit/D --aZ, 0
1, lam` l ed as a(n)Contractor*/Engineer/Architect
(Please print name & circle license type) *FS468 Building Inspector
*Generat Buildin2(m
4e)
l or Roof/ Contractor or any Individual certMad under 468 F.S. to make such an Inspection.
On or about 1 did personal y inspect the roof deckpig
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Swor�,tp and subscribed before me this day of Kf V � V-20-D
Who Is personally blown to me or who has produced
as identification.
Notary Public, State of
Signature of Notary:
Commission Number:
En
(Seal)
MARLINA GODINEZ '
MY COMMISSION # GG114235
EXPIRES June 13. 2021
RECEIVED OCT'2 7 2017
current
(whichever