HomeMy WebLinkAboutInspection Docs SEBC TRSI 772-335-0343 p.1
07/06/201.2 09:52 77246264 SLC INSPECTIONS PAGE 61/01
Planning& Development Services
�! EDIT
Building&Code Regulation Division
2300 Virginia Avenue
COUNTY
a Fort Pierce, FL 34982
«- �--- 772-462-2165 or 772-462-2172
Fax.772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit . v
license Contractor ngineer/Architect
(Please pant name&circle license type) : ui ding inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspectioA.
On or about_ �7J I did personally inspect the roof deck nailing
(Date) pp��
work at: Z_S06 AltIJA4-Z�.
(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.)
�G 0-c-,-7 (rj
I-Aignature and Seal License#
STATE OF FLU
COUNTY OF n ` 4 t1 r � ^t
Sworn to and subscribed before me this '14- day of 2� 6"�'� 2D
by klj rk,, lrsl Who is personally known to me or Ao has produced
as identification
Notary Public,State of r'
Signature of Notary:
Commission Number_ 2.jqjjp JAI
AMEILA P.HARJHDDN
En 01/19/2011 Notary Public-state of Florida
' My Comm.Expires Jul 261 2016 missl
fag No Camon EE
219766
RrECEIVED FFR 12 .P"!!