HomeMy WebLinkAboutROOF INSPECTION AFFIDAVIT WITH PICTURE07/30/2012 13:20 7724688397 JA TAYLOR ROOFING PAGE 01/01
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax:772-462-6443
SCANNED
ROOF INSPECTION AFFIDAVIT BY
St. LUCip, cool K
Re: Permit#/ - '/ zc&
1, k�y /(Aife licensed as ontracto ngineer/Architect
(Please print name & circle license type) 'F 6 Bw mg Inspector
*Genenal, Building, Residential arRaoJmg COntractoror any individual cerb/ied under 468 F.S. to make such an inspection.
On or about 1 did personally inspect the roof deck nailing
ate �j r
workat .5711/ C�O Ate (i/y6le (r/-1 7L
(Job site address)
Based upon that examination I have determined the installation was done according to the Hurricane
Mitigation Retrofit. Manual (Based on 553.844 F.S.)
Sign ture and Seal
STATE OF FL O I A
COUNTY OF MJF_
License #
Sworn yto✓� 7d subs sr bw- before me this (�J da L`� 20��''�
by Jam' /t `(/ /f'r� Who is pe ally known to me or who has produced
as identification.
Notary Public, Statecof ELgn/,.
Signature of Notary: �qn !! /�' •r�
Commission Number: (Seal)
En o1/ig/2011 NOTARY FOBLIC-STATE OF FLORIDA
Karen 5. Nielsen R E C E
;CammissioaADD1000356 i r^� --.
6,, Expires: JUNE 12, 2014
aavnsa 1mro &tuexncaonu%w,ma
Jul- 3 P 2012
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