HomeMy WebLinkAboutRoof Inspection AffidavitPlanning & 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
Re: Permit #
licensed as a(n)Contractor*/Engineer/Architect
(Please print name & circle license type) *FS468 Building Inspector
*General, Building, Residential or Roofing Contractor or any individual certified under 468 F.S. to make such an inspection.
On or about - 1, ��0 / '; 1 did personally inspect the roof deck nailing;
Date
work at: 74,7 & Ale —
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of the Florida Existing Building Code Section 708 or the product approval submitted (whichever
is
Signature and Seal License #
STATE OF FL
O41tQ,1b
COUNTY OF
to and Abbscribed
Signature of Notary:_
Commission Number:
En
4 day of 2Q
)w o is personally known to me or who has produced
as Ierlii:ification.
(Seal)
KAR S. NIELSEN Cornrnission MY Cornm# FF 115637
ission Expires
-- UnF?2. 2018