HomeMy WebLinkAboutInspection Docs 2015-08-25 12:53 j.a.taylor --1-nfing 772 468 8397 >> P 1/1
_ Planning& Development Services
Building &Code Regulation Division
2300 Virginia Avenue
Port Pierce, FL 34982
772-462-2165 or 772.462.2172
Fax:772-462-6.443 REC
ROOF INSPECTION AFFIDAVIT X13
Re: Permit# ~ '
I, licensed as Contractor'"/Engineer/Architect
(Ple print name&circle license type) 468 Building Inspector
*General,Building,Re entlal or Rooflng contractor or any individual certified under 468 F.S.to make such on Inspection.
On or about I did personally inspect the roof deck nailing
/79
work at / 'i"&'
(job site 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.)
j
Signature and Seal License#
STATE OF FLORI
COUNTY OF
i"
Sworn to subscrl d b fore me this day of
by Who Is personally know to me or who has produced
as identification,
Notary Public,Stat F r'
Signature of Nota
Commission Number; (Seal)
En 01/19/2011
" KAREN S, NIELSEN
5 715(137
Commission 8 F
commis9ion Expiies
2018
6,