HomeMy WebLinkAboutRoof Inspection Affidavit Planning& Development Services
Building&Code Regulation Division
2300 Virginia Avenue
_AM6 Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#
I, licensed asn)Contractor /Engineer/Architect
(Please print n e&circle lic nse type) *FS i ing Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about 1;)401- 15 , 1 did personally inspect the roof deck nailing
(Date)
work at: 'Z� . 0 Q"Q-Ck C) r l(A N
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of the Florida Existing Building Code Section 611 or the product approval submitted (whichever is
most strigent).
U � 1� CCC 133 0 8116
Sign ture and Seal License#
STATE OF FLORIDA.
COUNTY OF
Sworn to and subscribed before me this IS79'- day of eM4/- 20z ,
by 1Q i ay�Tqct m 4e!-2� Who is personally known to me or who has produced
as identification.
Notary Public,State of Flori �j //JJ
Signature of Notary: %� 7�'nn ;�i�" sMANE R P MM
Commission Number: 1=(= ]� j- (S •'e My COMMISSION F FF202LIS
EXPW&S Ferry 24.2019
En 01/19/2011 Nor�i�e o