HomeMy WebLinkAboutRoof Inspection Affidavit sr Public Works Department
.. Code Compliance Division
2300 Virginia Avenue
• R 1 • A Fort Pierce, FL 34982
772-462-2172 Fax: 772-462-6443
INSPECTION AFFIDAVIT
Re: Permit#
I, 5—leuet`1 laN'�l t , licensed as a( Contractor* ngineer/Architect
(Please print name&circle license type) *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 [— ( 5-- 144 , 1 did personally inspect th f dec�nallin e and/or
(Date) (circle those that apply)
secondary water barrier work at: g lq tD��N PS
(Job site address)
Based upon that examination I have determined the installation was done according to the
Hurricane Miti n Retrofit Manual (Based on 553.844 F.S.)
osss Llo��i
Signature and Seal License#
STATE OF FLORIDA
COUNTY OF d VAl J \�
Sworn to and subscribed before me this ,5 day of Ick4N 20__C
by eys(AS+O ri`j O'kWho is personally known to me or who has produced
�•L-to �^ -r__ as identification.
s
Notary Public,State lorida oEAN�A Sta e of fi°2o16 '
Signature of Notaryf jyY PUg�, N01acy PubEXp,teS QeC 1661
g � :My °mm• EE 658 �.
Commission Number: - S$�� '2('y _ ��a��s+°o# lwaq Assn
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En 09/17/09 T;;F,;;�`•` 6°ndedl ,.;,�.;,..--��`"