HomeMy WebLinkAboutROOF INSPECTION AFFIDAVIT2018-11-13 09:52 M ^lo Roofing Inc. 17728789051 >> 71"1"",)626443 P 3/3
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fore Pierce, FL 34992
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re'- Permit #
I, 61Alicensed as a(n ontractor'" ngineer/Architect
(Please print name & circle license type *FS468 Building inspector
*-
St t deAa
Q)4�ent
*General, Building, Residential or Roofing Contractor or any Individual cerdfled under 468 F.S. to make such an Inspection.
Or or about II 2 /v I did personally inspect the roof deck nailing
(Date}
work at; A)& 56 -116� l� , f ��. )rZ 94kM
8CB NcD
St LUU6 (;oUnty
(job site address)
Based upon that examinatio ave deter ned the installation was done according to the current
edition of the F Exi ng Buildin de Section 708 or the product approval submitted (whichever
is most s ' nt
Signatup6 and Seal
STATE OF FLORIDA
COUNTY OF � . UC-G( e
Cc c / 33 / ZO 7
License #
Swjprn to and subscribed before me this i da of \14V 20
by!�C�S��VA 5� ir'1 t C3fC��f', Who i(personally known tome rwho has produced
as identi'fiiatfon.
Notary Public, State of Florida
Signature of Notary
Commission Number: (seal)
En'
CHRISTINA K. RAWLINGS
-�r •
Notify Public, - State oS Florida
;� . Cbnnnls�IGp N F,t, 973677
E%ptril'lAir.2x .202
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