HomeMy WebLinkAboutRoof Inspection Affidavit Public Works Department
y r: Code Compliance Division
, COUN 2300 Virginia Avenue
• R I . A Fort Pierce, FL 34982
772-462-2172 Fax: 772-462-6443
INSPECTION AFFIDAVIT
Re: Permit# d 3 3�
I,4 rt a'.4 kysj c,,,,1 , licensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle license type) *F5468 Building Inspector
*General,Building,Residential or Roofing contractor or any individual certified under 468 F.S.to make such an inspection.
On or about —21— /� , I did personally inspect the roof deck nailing and/or
(Date) (circle those that apply)
secondary water barrier work at: G G0 7 P /on
(Job 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.)
O'��3c�21
Signature and Seal License#
STATE OF FLORIDA
COUNTY OF .SIL L V e 14
Ss ``t����o��a��nd��subscribed before me this�day of oit 20
by xs�p,A oe_kk _) Wch persona y o me or who has produced
ast .
Notary Public rida •RYP,ota 6a.
LASHAHNA INGRAM
Signature of Nota 2«`
Notary Public-State of Florida
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Commission Nu r: y Comm.Expires Dec 20,2018
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Commission#FF 177249
En 09/17/09 Bonded through National Notary Assn.