HomeMy WebLinkAboutROOF INSPECTION AFFIDAVITPlanning & Development Services
Building & Code Regulation Division
2100 Virglhia Avenue
Fort Pierce, FL34982
772-462-2165 or'772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Permit # 0 � 01
(5V40qql;-licensed as a(n)Co.ritractor*/Engineer/Architedt
print name & circle license type) *F5468 Building: Inspector
Building, Residential or Roofing Contractor pronyindividual certified under 468 F.S. to make. such on hjspectloh.
or about 'KW.OJ I did personalty inspect the roof deck, nailing
(Date),
rk at: Adlm��
(Job site, address)
upon thateXamiriation I have determined the installation was done. according to the current
,I of the. Florida Existing 'Buildift, Code Section 708 or the product approval -submitted (whichever
and Seal
(2 k�" 's. CC-.0
License #
ATE OF FLOR i-It
RUNTY OF
vorn to and subscribed before me this /Kday of 20i?
e CON AiiGiN -f, Ar it Who -is, persoq#ffV'known )tome or who has produced
otary Public, Siate:of Florid
gnature of Notary:
)mmigsion Number, U (Seal)
AUDW RKMMV
FF-1
EXPIRES : Much 6, 2M74M