HomeMy WebLinkAboutROOF INSPECTION AFFIDAVITPlanning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or772-462-2172
Fax:772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# 5LC - 1101- 0q 37
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APB �1991 F2Fo
s
o 1911,
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CGC/P ^PAS
,
F. Roelicensed as a(n)Contractor•/Engineer/Architect
(Please print name & circle license type) •FS468 Building Inspector
SCANNED
St. tUca CoU,7ty
*General, Building, Residential orRoofrng ContrWor or any individual cert$ed ander468 F.S. to make such an inspection.
On or about CO) 3 15 1 1 did personally inspect the roof deck nailing
(Date)
workat: S 9 /yr- !VA -
(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 strige ).
Signature and Seal
STATE OF FLORIDA
COUNTYOF ,R. %G•e--
ems .► ?a ('� S wr
License #
Sworntoand subscribed before me this ) 5 day of W(- A 20 � l
by d lq l iZa 2 Who is personally known to me or who has produced
as identification.
Notary Public, State of Florida
Signature of Notary: �—t
Commission Number: GTWOWo -7 ZZ (Seal)
KEN
RESEG2606670, 2012