HomeMy WebLinkAboutROOF INSPECTION AFFIDAVIT 4-12-18ouTY�
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Re: Permit #
r �V-N MIN U��
(Please print name & circle license type)
PI nning,& Development Services
G3NMH")
Building & Code Regulation Division IteceNED
23?0 Virginia Avenue
Fort Pierce, Fl. 34982 APR ,.. 2 ?a
771-462-2165 or 772-462-2172
Permitting Department .
Fax: 772-462-6443' St. Lucie co,inr,
'Ab-3
*General, Building, Residentioi or Roofing Contractor or any i
On or about 1 I 1 JY , I did pe
(Date)
work at:
licensed as a(n)Contractor*/Engineer/Architect
*FS468 Building Inspector.
certified under 468 F.S. to make such an inspection.
onally inspect the roof deck nailing
(Job site agdress)
Based upon that examination 1 have detern•
edition of the Florida Existing Building Code
most strigent).
5ignatur and eal
STATE OF FLORIDA
COUNTYOF
Swor o and subscribed before me this_
Who
• as id'
r
Notary Public, State of Florida d
Signature of Notary:
Commission Number. rf
En 02/29/2011
i the installation was done according to the current
tion 611 or the product approval submitted (whichever is
ccc 13360 j
License #
20
me or who has produced
(Seat)
ROBERTBRUNKE
Notary Public - State of Florida
' Commissim. A GG 176972
My Come. Expires %lay 12. 2022
"conded;hrougi Naional NolaryAssn.
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