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Building.&Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL,34952
�,I;�� 772-462-2165 or 772-462-21.72
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W:�elM�iu�.iA ;�i'�`•:�1 d:6tvi� �� r Fax:772-462-6443
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ROOF INSPECTION AFF)DAV1T
Re: Permit#
I, r lL.tr r�75 licensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle license type) *FS46a Building Inspector
'General,6ulldinl7,Resid ntial A Roofing Contractor or any individual certifled under 468 F.S.to make such on inspection.
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On or about o l s did personally inspect the,roof deck nailinr=
ate
work at: ip toe-q e—.5 Gl
(job site address)
Based upon ami tion l have determined the installation was done according to the Hurricane
Mitigat' Rgtrofit Man I(Base .844 F.S.)
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Signature S License#
STATE OF F•f QRI A
COUNTY OF 7:/—uo / QJ
SwornLto and s b ribed of9re pie this day of c c�'ry�, � 20LS
by ,�. � 9 ' aL i/� - Who is personally known to me or who has produced
as Identification.
Notary Public,SFate of Florid „
Signature of NQ-a c tib”`4o;�t GAIL A.t'EVMAN
Commission Number: 4J .ijjey tars Public-state of Florida
My Commission Expim Jan 4.2019
En 01119/20n %,,;o 1'IN COMMISSIon IM FF 074781
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TO/T0 30Vd QOdd JNIa-iing G3I-nd 60kZ-99V-ZLL Eb:ZT 9TOZ/50/02