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Planning&Development Services
^�... j`'I-J,i Building&Code Regulation Division
2300 Virginia Avenue
a Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# 0
1, , licensed as a( EBuil
PgInspeCtor
/Engineer/Architect
(Please print na e&circle license type) *F5 5
*General,Building,Residential❑r Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about l7ZZ,5-_ . I did personally inspect the roof deck nailing
(Date) f , �`f
work at: -76,� L U l,� ST
(Job site address)
Based upon that examination I have determined the installation was done according to the Hurricane
Mitigation Retrofit Manual (Based on 553.844 F.S.)
S n ture an&4eal License#
i
STATE OF FLORIDA F
COUNTY OF 2n zt/ e �
�-y , q
Sworn to 2r subscribed before me this I day of 20 '
by ncow / Cff4o Who is Personally known to me or who has produced
as-identification. ^
Notary Public,State of Florida
Signature of Notary:
Commission Number: (Seal)
En o1/19/70X1 /�f"''' ;DAVID VANDERFLIER
MY COMMISSION#FFOe9aw
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