HomeMy WebLinkAboutInspection Docs Planning&Development Services
Building&Code Regulation Division
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2300 Virginia Avenue
Fort Pierce,FL 34982
772-462-2165 or 772-462-2172
Fax:772462-6443
ROOF INSPEMON AFFIDAVIT
Re: Permit# Is
I, ,5i ei/7ic1c - .licensed as a( Contr�,,acto * Engineer/Architect
(Please print name&circle license type) *F uilding inspector
*General,Building,Reodentfal or Roofng Contractor or any indmduaf cerbfred under468 FS.to make such an inspection.
On or about if ! ,I did personally inspect the roof deck nailing
(Date)
t
work at: 270'7 U ufi t
(lob site address)
Based upon tha examination I have determined the installation was done according to the current
edition of F fisting Building Code Section 611 or the product approval submitted(whichever Is
most f
L'66-09Y4�7 3 ?
Signature and Seal License#
STATE OF FLORIDA -
COUNTY OF
vrt to and s scribed before me this ! day
S
byre who is personally own a or who has produced
as identification.
Notary Public,State of Florida
Signature of Notary.
Commission Number: (Seal)
En 0:./19/20u
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