HomeMy WebLinkAboutInspection Docs 2015-07-31 14:48 j.a.tayl.or 772 468 8397 >> P 1/1
Planning & Development Services
Building&Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772.462.2265 or 772.462-2172
Fax:772-462-6443
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ROOF INSPECTION AFFIDAVIT
Of
Re: Permit#z50-&--4- VS
licensed as a0 ontractor En gineer/Architect
(Plea Te'Print name.&circle license type) *FS4 nspector
*General,Building,Residential orRoaling Contractor or any Individual certified under 468 F.S.to make such an InspecTion.
On or about I(Jlv 2 9,01,q , I did personally inspect the roof deck nailing
(Date)
work at:
(job sit address)
Based upon that examination I have determined the installation was done according to the Hurricane
Mitigation Retrofit Manual (Based on$53.844 F.S.)
License#
STATE OF FLJO
COUNTY OF
Sworn to �qsubscribed before me this d of—]j1-/—V20S
by 4�
VIP %jho is pe nally knowntome or who has produced
identlfl
t
Notary P ic S F
.Z4e.e4a
Signature of Notary:
Commission.Number; (Seal)
En 01119/2011 KAREN S. NIELSEN
commlq�1011 41 Fr.11 W7
ission Expires
10 My ConlM
june 12. 2018