HomeMy WebLinkAboutROOF INSPECTION AFFIDAVITplanning,,&., Development 'Services
Building & Code Regulation Division
2,300, Vi . r9iIiI.O.Aven4g,
FoMPierce, FL34982-
772-4.624.165'or 772-462=2172
Ftix: 172-462-6443
ROOF, INSPECTION AFFIDAVIT
eel&
Re: Permit # VA k a-_ 015.. 33
� C_ensbd,a. s a(,rqZ:onracto /Engineer/Architect
(Please Dw ,anA -NTkLapd-Craq:t:�
print parne,& circle license type) 4S468,Building Inspector
*General, Building, ResidentialbrRooflng Contractor or any indil)idual-tertlj7ed.-Under'468 F.5-to make such. an inspection.
On or about, Sl I raol I did personally 4[nso.iE'(3',the roof deck.nailing
:work at: e
(job site address)
Based- U00n that
hat 6xarh.iftati,ojl.lhgve.,,,determ . ihed the. insta.1118flQn.was done according to. the current
edition of the Fioridd Exi'sfift -Building, Code Settiori 708 or the product approval submitted (whichever
is' ost strig6ht
signa.ture,and sead.,
w, �b bs acv-)4
Lice.nse,#
STATE OFIFLQRIPA
COUNTY OF MOZr, tf\
Sw rn-to and -subscribe ,4-before me this day of \k0J CAL 20 Jk
Who -is personally known tome or who, has produced
as identification.
Notary Public, State ofMP 1�ddftt
Signature'qf Notary:
Comrrils.sionNumber:
N b1iC_.S6teofF1cdd'a
En otar$ PU S pIotijmtGG 7477
k S �9 02i
4yCCOMM, Aqrl , 2