HomeMy WebLinkAboutInspection Docs f-
Ptatining&D.evelopmetit Services
Buildirig&Cone Regulation Division
2300 Ur"girlia Aver>ue
Fort Pierce,FL 34992
.K A9OW
172-462-2165 or,7714462-2172
Fax:712462-6443
ROOF INSPEC33UN AFFIDAVIT
Re: Permitowk-9��9lli
1, 1139AD 5. f�J rlr , licensed as a(riContractor* Engineer/Architect
(Please print name&circle licen'se.type) FS468 I rispector
*Gerrerdt,Bantling,Resldentlaf or Roofing Cantractor or ony In0t4duol cerrifled under 468 f:S,.Y'a make such an Inspection.
On or about o2 G9 , t did personally(aspect the roof declt railing
4 ate)
work at: ! Ivy, Dn E
(Jolt site address)
rased upon that exarfriration i have deterrhined the installalion was dorie according to the Hurricane
Mitigation Retrofit Manual (Based on 553-84.4 F.S.)
3,2 13
Signature and 1 license# -
STATE OF rLORIDA
COUNTY OF t
Sworn to and subscribed before me this /15"day of
n 24
by � lh� a!th �
has produced
as ideritifiication.
Notary Public,State of Florida �0Y¢' M6EIWAY
Signature of Notary., _ rpy�ae ,� *ARY C4116ii�S1(icI�SES1tYT42
--^—� ��Sr.NfeTdti'��c"Illy
Commission Number;_ ,: 'r r (Seal) fl 8a edThtu t#odtYS v{c s
En 01/19J2012 41�
d sos�` �N DNIJ008 IVNIGM wdlz:t