HomeMy WebLinkAboutRoof Inspection Affidavit Planning& Development Servicos
QA
Building&Code Regulation Division
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2300 Virginia Avenue
FortP erce FL �
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HIM
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X72-462-2165 or 772-462-2172
Fax: 072-462- 3
8!29F ffieICTION AFFIDAVIT
Re: Permit# o-cg'-1-C1(0 I
1, I''a �'r ✓��' licensed as a Contract /Engineer/Architect
(Please print name&circle Ii ense type) *F5468 Sul ding Inspector
'General,Building,Residential or Roofing contractor or any Individual certified under 468.P.5.to make such an inspection.
On or about S/ /,15 _, I did personally Inspect the roof desk nailing
(Date)
work at: -55/.�7 o , �/vj
(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 or the product approval submitted (whichever is
most strigent).
Signature Ad Seal License#
STATE OF FLORIDA
COUNTY OF
5warn to nd sybsed be ore me this„ �_day of� zoJS,
by iso rte!�w�' sr' who Is personally known to r6e or who has produced
as Identification,
\\\011!O l I I�l 161 t/r0
Notary Public,State of IN Id '' `�\vo\�gAUNK� : i,
,. Q �'s
Signature of Notary: +`e`°.°'g10N E6, r:
Commission Number: L s(SO�° 2o1p�F�
En 01/19/2011
RECEIVED
TO 30dd 80686PCZLL ZZ:Tz 5I0Z/06/00