HomeMy WebLinkAboutRoof Inspection Affidavit I
Planning& Development Services
Building&Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
- -- - ---- ^- - �- 772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# ev �ad
I, licensed as a Contracto /Engineer/Architect
(Please print ame&circle license type) *F g Inspector
"General,Building,Residential orRoafing Contractor or any individual certified under 468 F.S.to make such an Inspection_
On or about I did personally inspect the roof deck nailing
(Date) �^
work at: 4Wk-S,'111'q
Job site address)
Based upon that examination.) have determined the installation was done according to the Hurricane
Mitigation Retrofit Manual (Based on 553.844 F.S.)
57.Zd-
5lkn ture anaAeal License#
STATE OF FLORIDA
COUNTY OF � Gl/C/i
Swor to and subscribed before me this day of 20�
by t W Who is iLn nal) know to me or who has produced
as identification.
Notary Public,State of Florida
Signature ofotary;_, o
Commission Number: (Seal)
En 01/19/2011 D"10 VANDERF4IER
MY COMMISSION#FF099560
EXPIRES March 8,20'18.
RECEIVE 9 SEP 0 9.[(115 ,107)396-0163 F1orldallotsq$ervjw com
TOO# SZT'ON GZ88S9tZLL 'auI `O21tw I'at0 I:b:9I 9TOZ/80/60