HomeMy WebLinkAboutROOF INSPECTION AFFIDAVITPlanning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, Ft. 34982
772-462-2165 or772-462-2172
Fax:772-462-6443
ROOF INSPECTION AFFIDAVIT
Re'. Permit # ig0,(9,-0g33
I, V Fllicensed as a(n)Contractor'/Engineer/Architect
(Please rint name & circle license type) eFS468 Building Inspector
�Grrxrol, BwWing, Aeridrnrwi a AooJma Cm tvctor or ony Jndlwdual reroJred usher,168 F.5, to make "ban inspetr'O&
On or about *11 014 oto I did personally inspect the roof deck nailing
(Date)--`�---'
work at: aO f F kA1iv%V t �js—11'�,�[ �'f•
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Based upon that examination I have determined the installation was done according to the currem
edition of the Florida Existing Building Code Section 708 or the product approval submitted (which,
is most s 'ger
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i re and Seal License x
STATE OF FLO 14
CDUfM OF Si
SvgmmandsWFvibed bdorc meths 3i51 daYof I1cce mbe' 2011
by O kt mp ' . pro l4a ie> , Vft Is personally known to me or who has produced
� as ldetlt8lcation.
Notary Public, State of FIQnda
Signature of Notary: .�Q.{-(.1AOLA.11 �A�-�-p S� r'I`�
Commission Number: F qF $1 71 l (Se NOTARY PUBLIC
STATE OF FLORIDA
En COWTO lrl`%- e
Expires 214,202C
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'ceneroi, sugd M Restdentiot a
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On or about 44
(fib site -dress
Based u
Pon that examination 1 have determlroed
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edition of the Florida rxd t instal
sting Building Lode Swat n 70S asr t aaordin8 t'o the
is most
aPp vai U16VIted
re and Seal License #
x
STATEOFF
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ouNrr OF i • ;
by
Sworn to and subscribed before me this 3 r 5+
.Who is OfbWAnkL -_ 20
u oersonA4 known to me ar who ha; t �dund as Ide-ficatlon. -
Notary PubRG State of F� l ''
signature of Notary;
Comm[ssfon Number:En
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