HomeMy WebLinkAboutRoof Inspection Affidavit Planning&Development Services
Building&Code Regulation Division
2300 Virginia Avenue
i Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax:772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#
licensed as a(n) tractor Engineer/Architect
(Please print name&circle license type) *FS468 Building Inspector
*General,Building,Residential or Roofing 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: jbf!r / §C-JEZ I,4- DrL rT�C�Y.G� f�L 1f��Z
(Job site address)
Based upon that examination I have determined the installation was done according to.the current
edition of the Flori fisting Building Code Section 611 or the product approval submitted(whichever=s'"-•
most strige j.
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Signature and Seal License#
STATE OF FLORID -
COUNTY OF
Sworn subscribe Qre 20�
by nally own tome o ho has produced
Wentif ion.
o s�% D=WN
Notary Public,State of Flori ;• «�� Notary Public-
Signature of Notary: N. '=M Com State of Florida
4a y m.Expires.Mar 22,2017
Commission Number: �. Commission�Y,EE 877
Bonded Through 571
En 01/19/2011 9 National Notary Assn.
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