HomeMy WebLinkAboutRoof Inspection Affidavit Planning& Development Services
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Building&Code Regulation Division
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1,jx� t 2300 Virginia Avenue
Fort Pierce FL 34982
= j- 772-462-2165 or 772-462-2172
Fax- 772-462-6443
ROOF INSPECTION AFFIDAVIT
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Re: Permit#I
�L-c-1.05 , licensed as a(n)Contractor*/Engineer/Architect
(Please print!name&circle license type) *FS468 Building Inspector
General,Building,Residential or Roo mg Contractor or any individual certified under 468 FS_to make such an inspection.
On or about I �i � �� 1 did personally inspect the roof deck nailing
(Date)
work at: -i-`-"
(Job site address)
Based u at exa tion I have d termined the installation was done according to the Hurricane
M1 ' ation Retr it Ma ased on 553. 44 F.S.)
i
ignature'and
STATE OF FLORIDA
COUNTY OF �LzLi ,
Sworn to and subscnb d before me this 4/,L4.day of 20 IS
byC"*L5To ;QR. LLINS Who is personally known to me or who has produced
)RI J e2S>Zj LAWS e, as identification.
Notary Public,State of MOM
Signature of Notary: �4 .��, (;
Commission Number: rf-0 l7�/ ���(Seal) NAIL A.PEYMAN
Notary Public-State of Florida
En 01/19/2011 s".,� oma;MY Commission Expires Jan 4.2018
Commission N FF 074781
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