HomeMy WebLinkAboutROOF INSPECTION AFFIDAVITy
COUNTY
F L 0 R I D A
SCANNED
BY
aCOUiopment Services.
Building & Code Regulation Division.
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTIONAFFIDAVIT
Permit# O7- 6'773
S*s)t(U*_ , "1''y'0uu�censed' as a(n)Contractor*/Engineer/Architect
(Please print name & circle license type) *FS468' Building inspector
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General;. Building,. Residential or Roofing, Contractor or any, individual certified under 468'F.S.. to makesuch: an inspection..
nor about 6 1 did personally inspect the roof deck. nailing
�I (Date) .
rk at:
Based, upon, that. exam
edition of:-e
e F a E
is most nt).
II STATE OF FLORIDA
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fined the installation was done: according to the current
-Section 708 or the product. approval submitted (whichever
License #
COUNTY'OF 'S t"_ i-P_
Sworn to and subscribed before me this CIXI day of 8 20
by Q.ShU i sClrii-0dCA-zr'- • Who is personally y known tome or who has produced'
as identification.
Notary,Public, Sta. 'f 'rids
Signature ofN'ota
Commission, Numb r_!Lj�I q0 g11-4 7 (Seal)
En:
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LISR 1SARrE MONTELEONE
eL Notary Pubiic -State of Florida
CommissiomwGG t90497
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