HomeMy WebLinkAboutInspection Docs 2015-07-13 13:05 j.a.ta%,/,1l roofing =772 468 8397 P 1/1
Planning& Development Services
Building& Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772.462-2165 or 772-462.2172
Fax;772.462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# /
licensed as g Contract r Engineer/Architect
(Please print name&circle license type) nspector
'General Building,Residential or Roofing Contractor or ony Individual certified under 468 F.S.to make such on inspection.
r
on or about I did personally inspect the roof deck nailing,
(Date)
work at'
lob 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.)
Signature and Seal License#
STATE OF FL
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COUNTY OF
Sworn to d subscribed efore me this-,'5 day f
by Who is per ally k own to me or who has produced
as identification,
Notary Pubic, �SAZ0�
Signature O01c S
Commission Number: Q2 (Seal)
En 01/19/2021t
KAREN S. NIELSEN
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Commission a FF 115637
My commission Expires
June 12. 2018
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