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�. n �� � .� �� � ._z � Building&Code Regulation Division
2300 Virginia Avenue
COUNTY Fort Pierce, FL 34982
. 772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# 10�
I, ,M-ki C TGw(9t 4ac.q , licensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle license t pe) *FS468 Building Inspector
*General,Building,Residential or Roofing 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: L-351 -0et-i,�g-IT– W�
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of thejJofida Existing Building Code Section 611 or the product approval submitted (whichever is
most str' ).
Signature and Seal License#
STATE OF FLORID
COUNTYOF uC��
Sworn to and subscribed before me this 3C3— 20�
by �1 e-'"� personally known t me or who has produced
y as i n is
Notary Public,State of Florida
Signature of Notary:
Commission Numb( U (Seal)
En 01/19/2011 `�"',��.,�� ,
ANGEtA
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Z. Notary Public-S teo!Florida
;� Commlerlon I FF 234730
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