HomeMy WebLinkAboutROOF INSPECTION AFFIDAVIT•
0 0 WI-OW15
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982 A *0 �F�FrG
772-462-2165 or 772-462-2172 �^ . G® �o
Fax: 772-462-6443 st < 9 "A
Fax: d� j
OI
ROOF INSPECTION AFFIDAVIT
4 p B
��4di�7J
Re: Permit # / 1 "SJ S
CANNED
IA-S),"' Cw':@ T'censed as a(n)Contractor*/Engineer/Architect IN BY
(Please print name & circle license type) *FS468 Building Inspector Lucie CpU11fy
*Generdt, Building, ResidentialorRoo
fin
g
Contractor or any individual certified under 468 F.S. to make such an Inspection.
On or about ' O �" �� I did personally inspect the roof deck nailing
(Date)
work at: J' 0-0 (9 S
site ddress)
Basedi upon that
edition of the F
is most ent),
STATE OF FLO DA
COUNTiY OF
have deter fined the installation was done according to the current
gilding Xde Section 708 or the product approval submitted (whichever
C, ] 3 '3 1 a-o 7
License #
Sworn to and subscribed before me this _ day of lUo V-2r�
'n 24— 20
by SO %1CA6 .. S(!)ii 0e_C4I . Who is personally known to me or who has produced
as identification.
NotaryiPublic, Sta f rich
Signature of Nota
Commission Number:'
En
(Seal)
j .A - Pd°•USA MARIE MONTELEONE
;? •`1�F, Notary Public -State of Florida
�';f Commission -- GG 190497
'+�,',of .,{ ` My Comm. Expires Feb 27.2022
Bonded through Natlonel Notary Assn.