HomeMy WebLinkAboutRoof Inspection Affidavit oV,e c1(t_)) skI( Lc(_zCID . ° 1'
Planning&:Development Services
fi
Building:&Code Regulation Division
2300 Virginia Avenue
9 Fort.'Pierce, FL 34982`
.... : 772-462-2165 or.772=462-2172
Fax:1:772-462-6443
,ROOF INSPECTION AFFIDAVIT
C'
Re: Permitt J 0 5 6 1
CO ,: icensed as n)Contr-acto /Engine:er/Architect
(Please:print name&circle>license type) *F5468:Building Inspector
*General;Building,Residential or Roofing Contractor or any:individual certified under 468 F.S.to make.such an inspection:
On or about 5 I did personally inspect.1he roof.deck na'i(in
(Date)
work at: l:G
(Job_site address)
Based upon that examination I have.determined.the installation._was done according`6 the current
edition'of.the Florida-Existing_Building Code Section 611 or the product approval submitted (whichever is
most stri nt).
Sigifature and Seal License
STATE OF FLORIDA
COUNTY"OF.
Sworn.o and subscribed before me this""day of . . f) 1 20L,.
by PclS(�A Who is pe rs 11 'k kn�o to me:or who has produced
as identification.
`NotaryPublic,State of Flora ])i?;i
Signature.of Notary
Commission Number: gci$ (Seal).
En 01/19/2011
a o+"*"'M11, MYSS:HAMPTON
`Notuy'Public: State:et Floilda,;
N 'a? My Comm.Expires Jig I 2018
Commission N OF 1:19908
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