HomeMy WebLinkAboutRoof Inspection Affidavit2017-08-16 15:06 M,a_rzo Roofing Inc, 17728789051 » ?7a?4626443
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Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-4626443
ROOF INSPECTION AFFIDAVIT
Re: Permit
l5ay a_ &/OL�gicensed as a( Contractor* Engineer/Architect
(Please print name & circle license typ *FS468 Building Inspector
"'general, Building, Residential or Roaflng Contractor or any individual eerdfled underdM F.S. to make such on inspection,
J
On or about I did personally inspect the roof deck nailin
(Date)
work at:
�-�-� Aye, Fi
Based upon that examination I
edition of the Flor E
is most s nt).
Signature and Seal
(Job site address)
,ermined the Installation was done according to the current
Code Section 708 or the product approval submitted (whichever
License #
STATE OF FLOI� ] . , C'
COUNTY OF �1 L,.�
Sworn to and su scribed before me this day oft kw be,,-- 204
byS R VI�� Who Is personally known to me or who has produced
as identification.
Notary Public, State of Florida + -
Signature of Notary;
Commission Number; (Seal)
DAVIDtVANDERFLIER
Ent_ �' MY COMMISSION #FF090550
• •`a;"' .
EXPIRES March 9, 2018
(no7)ooa,ofa.7 FlarldoNo�orySONlce,com
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RECEIVED. SEP 15 2017