HomeMy WebLinkAboutInspection Docs 01/21/2016 03:20 7722190931 THE UPS STORE 3023 PAGE 01/01
Planning&Development Services
I% Building&Code Regulation Division
* 2300 Virginia Avenue
Fort Pierce,FL 34982
772-462-2 .65 or 772-462-2172
Fax:772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit k5an—c' r Oo'�a
licensed as a(n)Contractor*/Engineer/Architect
wlei se print name&circle license type) *FS468 Building Inspector
`General,Building,Residential or Roofing Contractor or any Individual cerbried under 468 f S.to make such an Inspection.
On or about I did personally inspect the roof deck nailing
(oat )
work at:
(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 FLORIDA
COUNTY OF. Marlin,_,
vU
Sworn to and subscribed before me this day of 20,
by --. Wha is perso y knowe or ho has produced
as identification_
Notary Public,State of:*'
Signature of Notary:_
Commission Number: � ,G�'C4 bR
ALY86 HAM!'10N
En 01/19/2011 � Notary Public-State W Florida
y My Comm.Expires Jul Is,2018
Commission#FF 1199011
RECEIVED JAN-22 2016