HomeMy WebLinkAboutRoof Inspection Affidavit emxa, -. � ,w,mu. ew.wwraenom ac .n.«n Planning r Development Services
e Building&Code Regulation Division
2306 Virginia Avenue
Fort Pierce, FL 34982
772-462-216S or 772.462-2172
Fax:772-462-6443
. .IP 2io iQN AFFIIDAVI`T
Be; Permit#150.5 "d
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licensed a3 a(n)Contraetor*/Engineer/Architee4
(Please print name&circle lice6se type) 'FS468 Building Inspector
General,Suliding,Residential ar Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about S�Y I did personally inspect the roof deck nailing
(Date") / 1�
work at: 386 A — (,` rA 9,
(Job site address)
Based upon that examination I have determined the installation was done according to the current
1 edition of the Florida Existing Building Code Section 611 or the product approval submitted (whichever is
most strigent).
CCC 13Ld Of
Signa r d Seal License#
STATE OF FLORIDA
COUNTY OF�J"Lrc, ° .
Sworn to and subscribed before me this '21,� 20�,
by e wis ersonally known me Jrwho has produced
as identification.
Notary Public,State of Florida
Signature of Notary:
Commission Number: 0ti� �ifiiitse//
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