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HomeMy WebLinkAboutRoof Inspection Affidavit SEBC TRSI 772-335-0343 p.1 07/06/2012 09:52 77246" '3 SLC INSPECTIONS( PAGE 01/01 �-rMIM Planting Development Services Building&Code Regulatiion ®ivisi®n 4 23DD Virginia Avenue r FL 34992 Font Pierce, 772-462-2165 or 772-462-272 Fax: 772-462-6443 ROOF iNSPEMON AFFIDAVIT � Re: Permit#t 150 — p0(�j licensed as a( Contra -Angineer/Architect (Please p nt name&dreie license types �F t ding inspector *General,9uilding,Resiaentiol or Roofing Contractor or ony individual certified under 466 F.3.to"make such an inspection. On or about ~ I did personally inspect the roof deck nailing (Date) work at: (job site address) Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.) 77 (? Signature and Seal License# STATE OF FLORIDt4 COUNTY OF � o Sworn to and subscribed before me this �` ZO by �a.,�„�.-cz ��(��.J w ersonallyknownI me or who has produced —�F'� as identification. .',. _ -_ r , t_; ,1111111.E IIA�ME ORTIZ o��� Notary Public-state of Florlda Notary Pubiic,5ta a of o /) _ My Comm.Expires Jun 1.2018 _ Signature of Nota G`^"'—t- +�F �oR` Commission#FF 111485 Commission Number_ a A 9 Bonded Through National Nota_ Assn. En 01/19/2011 RECEIVED MAY 08 2015