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Building&Code Regulation Division
2300 Virginia Avenue
Fort,Pierce,-FL-34982
mrr- - 772-462-2165 or 772-462-2172
Fax:772-462-6443
RECEP.":-D JUL_2 92015 ROOF INSPECTION AFFIDAVIT
Re: Permit#
1, �r✓V. r licensed as"a )Contractor* Engineer/Architect
(Please print name,&circle license type, `FSj68 Building Inspector ;
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
r _ . _ .
On or about ?®—/ _, I did personally inspect the roof deck nailing
(Date)
work at: �{gDS NV1i��AfJ �1 S AVE: -EMe�
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of t F Existing Building Code Section 611 or the product approval submitted(whichever is
most st e -
ST-.q� f�cw►�-f
Ccr-o 5-55-73 .2 w2,99
Signature and Seal License#
STATE OF FLORIDA
COUNTY OF
Sworn to and subscribed beforeme this 8kA day of 5 2015
b)ISteey e,n-e a,s$o v-.!%N4.N . Who is personally known t e or who has produced
1;%,0 L- — r_as identification.
Notary Public,_Stat - lo_rida —_
Signature of Notary:
Commission Number: 465 (Seal)
En o09/2o11
i
DEANNA GIVENS
"aYP"a� Notary Public State of Florida
Sr°O. •° Ex fres"Dec 16,2016
My Comm. P
Commission#EE 85876Assn.
��4rF of e� .Bonded Through National Notary
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