HomeMy WebLinkAboutFilled Land Affidavit Planning & Development Services
1 f
_ ` Building& Code Regulation Division
K-J' COUNTY ,Age 2300Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# N O
I,Mur—teie� 0W-kk ,& , licensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle license type) *FS468 Building Inspector
*General uilding,Residential o oofing Contractor r any individual certified under 468 F.S.to make such an inspection.
On or about 05 l Or IS , 1 did personally inspect the roof deck nailing
(Date)
work at: -14 06
(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).
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Signature and Seal License#
STATE OF FL
COUNTY OFORID - E-
Sworn jo a subscribedbefore me.thi day of U AV 201
by Ill1 o is personally known to me r who has produced
as identification.
Notary Public,State
Signature of Notary:
Commission Number: (Seal)
En 01/19/2011
;;�ti''ry''•. BRITTANYSMITH
.; MY COMMISSION#FF 124056
a' EXPIRES:September 16,2018
Bonded Thru Notary Public Underwriters
RECEIVED MAY Y pm�