HomeMy WebLinkAboutRoof Inspection Affidavit (2) P.1
Planning&Development Services
Building&Code Regulation Division
2300 Virginia Avenue
Fort Pierce, Ft,34982
772-462-2165 or 772-462-2172
Fax:772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit
licensed as a(n)Contractor*/Erigineer/Archftect
(Please print name&circle license type) *FS468 Building Inspector
*General,130dthy,Residential or Roofing Contractor orany individual certified under468 F.S.to make such an inspection.
On or about 1 aG/Z01 t,— I did personally inspectthe roof deck nailing
(6ate) I
work at:
(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'l/
GCS
sifiture and Seal License#
STATE OF FLORIDA
COUNTY OF t-0<:kP-
Sworn to and subjcTibed before me this ZC, day of :7—c--V" 16,
2D
by �%Y' NQA'LCr4!k —.(INho is personally known ome rwho has produced
as identi cation.
Notary Public,State of Flori
Signature of Notary: I--�tAl-
Comml%rion Number:—Vs,�� (Seal)
En 01/1912011
!0�8&flt51
FA,
014 41
17
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