HomeMy WebLinkAboutRoof Inspection Affidavit1012712017 15:12 LUVIANO ROOFING TA463 357 3566 P.0041004
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
1A).
Re: rmit # r v"
I lil used- as a(n)Contractor*/Engineer/Architect
le se print name & circle license type) *FS468 Building Inspector
*Genero4 Building, Resident 1 or Roof i' Contractor or any individual cerepel under 468 F.S. to make such an inspection.
On or about ��/:? I did personal) ns ct the roof deck nailing
(Date) . 1 / _ t %%
work at:
Based upon
editl4of o
is mot strip
STATE OF Fl. RI
COUNTY OF
(job site address)
examination I have determined the installation was done according to the current
irlda Existing Building Code Section 708 or the product approval submitted (whichever
and Seal
r/�7 —?Tf—
jr;27 ,
License #
Sworn to and subscribed before me this 2-1 day of (X f0b ti� 201-.�
by fYc,-,i.( 1 I,I AAf ra no .. Who is personally known to me or who has produced
as identification.
Notary Public, State of Fjgrlda.,, 4 f
Signature of Notary:
commission Number: (Seal)
En
NIARLINA 00DINi=z
*'my COMMISSION # GG114236
EXPIRES June M 2021
RECEIVED OCr'2 7 2017