HomeMy WebLinkAboutROOF INSPECTION AFFIDAVITRe: Permit # At-)03 —0(C' 13
I, ehsed as a(n)Cont
(Please print name & i(f$ license type)
*General, Building, Residential or ofihgrac� c
On or about -, 'S' 'L i U I did
(Date)
work at: -1 as-
lanning & Development Services
uilding & Code Regulation Division
300 Virginia Avenue
Drt Pierce, FL 34982
72-462-2165 or 772-462-2172
772-462-6443
r*/Engineer/Architect
*FS468 Building Inspector
ual certified under 468 F.S. to make such an inspection.
ally inspect th roof deck nay it
(Job site Oddress)
Based upon that examination I have determ
edition of the Floridan xisting Building Code
is most strieent). \ \
a6d`Seal
STATE OF FLORIDA
COUNTY OF �. o
1-10 to and s cribed �elo�ethis day
by Who is personal
as identification.
the installation was done according to the current
on 708 or the product approval submitted (whichever
License #
)ruanPg 20X
known to me or who has produced
Notary Pu ' , to
Signature of Nota
Commission er: (Seal)
En
W.TAlliVA IN6Rl1Nl C) i
Siate of Florida � S'
apa«�y'��'yrCsoinfYl.iG1YCsPau 2%2A98 _ O
77Tr24� C
s-sion
° UI O999392
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