HomeMy WebLinkAboutRoof Inspection Affidavit Planning&Development Services
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:�, .�:�• - - •-•• Building &Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2772
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#
I, licensed a a{n)Contractor*/ gineer/Architect
(Please print n e&circle license type) nspector
`General,Building,Resiid/entiol or Rooting contractor or any individual certljled under 468 F.5,to make such an inspection.
On or about I did personally inspect the roof deck nailing
(Date)
work at: goo / !,�'/ ►! lC'G
(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.)
li"Alclsm cc_— Cos 5//0/13
Sign ture andA eal License#
STATE OF FLORIDA
COUNTYOF S�r /e-
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Swor ,,to and sZu/;.
Ped before me this day of
by Who is personally known to me or who has produced
as identification.
Notary Public,State of Florida RECEIVED NOV f z 2015
Signature of Notary: ZO/ n
Commission Number: =1415Qa h (Seal)
En 01/19/2011 .".
4; 4,�, DAVID VANDERFUER
1.i"'
'` 1.) MY COMMISSION#R:099650
QTc F-S March 8 207$
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