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
ST
ROOF INSPECTION AFFIDAVIT
Re: Permit # / 2 1P " 63 s- 1
Jamie Cisco
(Please print name & circle license type)
ECEIVED
FEB 0 5 2018
licensed as a(n)Contractor*/Engineer/Architect
*FS468 Building Inspector
*General, Building, Residential or Roofing Contractor or any individual certified under 468 F.S. to make such on inspection.
On or about l 1 r . I did personally inspect the roof deck nailing
f (Date) 11
work at:/ 1 �Cn 1�l � lW as 13W
(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 611 or the product approval submitted (whichever is
most strigent).
CCC1327796
Signature and Seal License #
STATE OF FLORIDA
COUNTY OF Martin
Sworn to and subscribed before me this day of
by Jamie Cisco Wh�onaUv known to me or who has produced
as identification.
+o Peed Notary Public State of Florida
Marilyn Kluegel
Notary Public, State of FI i� My Commission FF 230179
Signature of Notary: r1 — oFa F-i pires 06/28/2019
Commission Number: (Sea
En 01/19/2011