HomeMy WebLinkAboutInspection Docs zix, 4..y, k ,,r Public Works Department
Code Compliance Division
I _
2300 Virginia Avenue
• . Fort Pierce, FL 34982
772-462-2172 Fax: 772-462-6443
INSPECTION AFFIDAVIT
Re: Permit#
I, ST�.�Crj licensed as n)Contractor*/ ngineer/Architect
(Please print name&circle license type) *F 8 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— LZ— 1 did personally inspect the roof deck nailing and/or
(Date) (circle those that apply)
secondary water barrier work at: 3-) � ( S �.r-.t.L
(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.)
Signature and Seal License#
STATE OF FLORID
COUNTY OF
Swo to and ubs ibed before me this _day of 20 1(
by, n—�i� UAv Who is personally Mown to m6 or who has produced
as identification.
Notary P i_c,State of Flor' a
Signature o _
Commission Number: EEI V2ol7 (Seal
...........
""". KAREN S. NIELSEN
En 09/17/09 ;;o`""Y P° --,
commission # FF 115637
o- My Commission Expires
June 12, 2018