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Planning & Development Services
Building & Code Regulation Division
2300 !Virginia Avenue
Fort Pierce, FL 34962
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
- ;,
Re: Permit #.r W
'ca", e as a(n)Contractor*/Engineer/Architect
(Please print name & circle license type) *FS468 Building Inspector
RECEIVED
4UG 0 7 7ojs
perrnittin9 Depart nt
St• LUe
Cie County
*General, Building, Residential or Roofing Contractor or any individual certified under 469 F.S. to make such an inspection.
On or about
11, I did personally inspect the roof deck nailing
(Date)
J
work at: V CIA, -
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of the Florida Existing Building Code Section 708 or the product approval submitted (whichever
is most strigent).
i D
Signature and Seal License #
STATE OF FLO I A
COUNTY OF J
Swol to,an subscri a before met is day of
by � �(� Clii.d- VVk Why is personally known to me or who has produced
as identification.
Notary Public, State of 51orida
Signature of Notary: l' 1
Commission Number. j (Seal) .
Notary Public State of Fl 2.
En Win=