HomeMy WebLinkAboutRoof Inspection Affidavit Sep.21.2015 14 :16 One Const(�--�r,tion Services 7723369379 0 PAGE. 1/ 1
Planning & Development Services
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uildin Code Regulation Division
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COUNTY 300 Vir inia Avenue
ort Pier e, FL 34982
72-462- 165 or 772-4622172
ax: 772-462-6443
ROOF INOECTION AFFIDAVIT
i
Re: Permit# '
I, , Iicans d as a(n)Contractor*/Engineer/Architect
(Please print name&circle lic nse type) *FS468 Building Inspector
*6eneral,Building,Residential orecoa cont r c or any individual ce ified under 468 F.S.to make such an Inspection.
On or about I did personally inspect the roof deck nailing
(Date) i
work at: ,80 X A � L
(job site a dress)
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Based upon that examinati I have determined the installation was done according to the current
edition of the Florida Exists 191
Buildl g Code ection 611 or the product approval submitted (whichever is
most strigent).
06 Z
Signature and Seal License#
STATE OF FLORIDA
COUNTY 4F
Sworn to and subscribed before thisda of 20S
by I Q wh is person Of
—knowWX me or who has produced
as id ratification
Notary Public,State of Florida
Signature of Notar : <""':p JENNIFORHANOb
Commission Number: 3 (Seal) ` �* MY COMMISSION#IINo
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En 01/19/2015 �'ov
RECEIVED SE `21 2015