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HomeMy WebLinkAboutROOF INSPECTION AFFIDAVIT _ Planning& Development Services
- j Building&Code Regulation Division
p 2300 Virginia Avenue
© s Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT ocl
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licensed as a(n)Contractor*/Engineer/Architect Cie count
(Please print name&circle license type) *FS468 Building Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.s.to make such an inspection.
On or about if ( 1 I did personally inspect the roof deck nailing
(Date)
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work at: 100 A,Vu-US(,Vj Qr;V?,
(Job site address)
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Based upon that examination I have determined the installation was done according to the current
edition of the Florida Existing uilding Code Section 708 or the product approval submitted (whichever
is o t striger>t
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Signa ure and Seal License#
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STATE OF FLORIDA
COUNTY OF �t- t ll�l
Sworn to and subscribed before me this
by_: Q V y-,V)n —�day of 20
Who is personally know�e or who has produced
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21dentific
Notary Public,state of Florida
Signature of Notary:
Commission Number: 4 '
' (Seal)
En
�P ELIZABETH OLNO
6 r
Notary Public-State of Florida
_• :•_ Commission d7 FF 9247 99
My Comm.Expires Oct 5,2019
'• •i-"• Bonded through National Notary Assn.u