HomeMy WebLinkAboutRoof Inspection Affidavit Planning&Development Services
Building&Code Regulation Division
2300 Virginia Avenue
K.
Fort Piercer FL 34382
772-462-2265 or 772-462-2 .72
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#
I, ",f is Lt t.w A2S , licensed as a(n)Contractor*!iEngineer/Architect
(Please print name&circle license type) *FS468 Building inspector
*General,Building,Residrentia or R afrng contractor or any individual certified under 468 F.S.to make such an inspection.
On or about I did personally inspect the roof deck nailing
{Date} ,
work at: 303 -y �i '1:�1— ' i� P, IF,
(Job site address}
Based upon examination I have determined the installation was done according to the Hurricane
Mitiga - n Retro ' anu 1 (Based on 553.844 F.S_)
r.
;t {` nd Se jE. License#
STATE OF FLORIDA
COUNTY OF`5`T''L i--1 C.t 12-1
Sworn to and subscribed bare me this / day of`�� 20
by&4PJ: ?�a2 t i1 tv_S Who is personally known to m who has produced
as identification.
Notary Public,State of Florid
Signature of Notary: ,���,,,,����
ti„ar o �,
Commission Number_- f"F'Q r//,�'�F/ ,'a l} GAl1.A.PEYMAN
Notary Public-State of Florida
En 01/19/2011 N, a.=W Commission Expires Jan 4.2018
�';'„o � ;•� Commis"sion#FF 074781