HomeMy WebLinkAboutROOF INSPECTION AFFIDAVITR
Planning & Development S �es
Building & Code Regulationlivision
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
1
ROOF INSPECTION AFFIDAVIT
_ I
�
Re: Permit #5 UA -64-6:� Sq,
1,licensed as a(n Contractor' Engineer/Architect 4%Co4
(Please print name & circle license type} "FS468 Building Inspector Q
. *General, BuRding, Residential
'�I� I did personally Inspect the roof deck nailinzoJJr RooJhrg Contractor or any Individual certdjied under 466 FS. to make such on Inspection.
OnQrabout l
I . Oil 7 �d
1
(Date) 1
work at.• ' 3 dl kc'J1
(Job site address)
Based upon that examination 1 have determined the installation was done according to the current.
edition of the Florida Existing Buildi g Code Section 708 orthe product approval submitted (whichever
Is most strigent).
% Signature and Seal License # C L t o 3479 r
STATE OF FLORIDA
COUNTYOF %JAbC
Sworn to and'subscribeedd before me this N day of 6riea� 20 d
' bye G I pen Who is personally known to me r who has produced
c"rtona.'I/ a _ Identificatlon -
r
Notary Pubilc, State of F dda ' testate oI Flonda•Notary Punk
I - Commissian RGG t82e42
.Signatureol'Notaryi '< ° YCommission e.atres
Commission Number.ell
Fo l
En
i-