HomeMy WebLinkAboutROOF INSPECTION AFFIDAVITBuilding & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982 kL Eo
772-462-2165 or 772-462-2172 4.15S
Fax:772-462-6443 !AN
Qe�Run9 �u!`ent
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ROOF INSPECTION AFFIDAVIT k9c
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Re: Permit# S C �� 00,
Intractor'"
rk ` S�iD licensed as a /Engineer/Architect 1)61
(Please print name & circle license type) 'F5468 Building Inspector
*General, Rulldna, Re Id Arlo, or Roofing Conrrrr eccttui or any indfvidaal cerdjied under468 ffS, to make such an Inspection.
On or about I ') i t did personally inspect the roof deck nailing
( ate
work at: �d Aak 104-'� &b
(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 611 orthe product approval submitted (whichever is
most strigent
Qt
Signature and Sea) License #
STATE OF FL DA
CDUNTYo +�
S� Deno ub crib �� g m�this d 2a I
bY�C CIv) .Who' personalty kn eme or wbo has produced
asidentifica ion.
Notary Public, State Ida �1_,
Signature of Notary: Milli
commission Number:
En 01119/2011
(Se "?wnuERREM.E5T00K
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EXPIRES: Oclober 7.r'a
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