HomeMy WebLinkAboutRoof Inspection AffidavitRe- -Permit 4 n
.,,licensed as.
(Please. ptint nameA circle1icense
*GePorgi, Buil.ding,.Resid.elntial.or.R,00f�ng'(bi
On or abou't
work at:, 0-5, Ar
Pased upon that. examination 1. ho
edition of the, Florida Existing Rpi.I.,
ism - Wstri t
,,, i 7r,"'. , - /--4� 'A,
atu re and Seal;;
STATE OFTLORIDA.
COUNTY OF I '11S
!Sworn foand.subscribgd before�me; - this
by Robtl-% CAU, V
Notary Public; State o I (iLt.7; - -
Signature of N6tary,
6tnhiissiob Nuffibe
Eh
Planning &IDevelopment Services
Building gtCode .Regulation. Divisibn
230OVirgirfla.Avenue
Fort- Pierce. FL 349.82
772-462"2,1-65- or 772-462,21,72
Fax.!, 772-462-6443
6(Woritractpir5�.,�.Rngineer/Ar hitect
*FS46,&,Bui.1dih9'lnspectoT
i -ractorar,any inqk1oup/ ceqifjed,u. nqd.er 468F.S. to make such an Inspectiort:
6k nailing,
did personal IVInspect the; roof -deck
et'k Wv
(j,ob-Mte addreps)
v, deternjinqd the ii-istallaticiD was done. according to the current
ding Section 708 or, the,pr (whicheverQduct approval: submitted.
License #
day:of2y,",\'te- 20
rn is personally known to meor \R6� has produced
itification.
L - .1 (Seal)
Jok MICHELLE-SINGLEY.
MY-dDM0fSSIOI4A'GGI04'00
'E(Plk> s June 91,