HomeMy WebLinkAboutInspection Docs Planning$t Development Services
Building&Code Regulation Division
2300 Virginia Avenue
Fort Pierce,FL 34982
IBM— 772-462-2165 or 772-:462-2172
Fax: 772-462-6443
80QF INSPECTION AFFIDAVIT
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Re: Permit# 4
1, licensed as a(n Contractor* Engineer/Architect
Contractor*
�tor*
k�
(Please print name&circle license type) *F$468 u nsipector
*General,Building,Residential or Roofing Contractor or any Individual cerrlfled under 468�S,to make such an Inspection.
On or about I did personally inspect the roof deck nalling
(Date)
work at: 6C
(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.)
Signature Land 1 License#
STATE OF FLORIDA
COUNTY OF L
Sworn to and subscribed before me this I'd day of
.by FWA)) 15. Who rsonall known who has produced
as ideniffidatlon.
Notary Public,State of Florida 0 DEMSE LEMAY
MY
Signature Signature of Notary: 00 EXPIRES,.March 23,2011
Commission Number (Seal) 8"dT
En oi/19/2o1l
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