HomeMy WebLinkAboutRoof Inspection Affidavit Planning& Development Services
- Building&Code Regulation Division
2300 Virginia Avenue
Fort Pierce,FL 34982
::•:-:,: :,..,,.,..,;,_•:::r_::.<..:.,,_,.�,. 772-462-2165 or772-462-2172
Fax:772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# Q �,
licensed as a(n)Contractor*/Engineer/Architect
(Please prin name&circle license type) *FS468 Building Inspector
I
*General,Bu(lding,Residenflat or Roofing Contractor or any individual certified under 968 F.S.to ma e such an inspection.
On or about 1 ,I did personally inspect the roof deck nailing
(Date). I
. � I
work at: SK
(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.)
- Co
S n ture an al License#
STATE OF FLORI
COUNTY OF
fSwor and su ribed before me this day of
by IE,R; . who is personalto me or who has produced
as identification
.
Notary Public,State of Florida
Signature of Notary:
Commission Number. {Seal)
En 01/19/2011 ,pr"_
r" DgVFD VANDERFUER
•i jR$ MY COMMISSION#FF020also
'�earM1W EXPIRES IMarch 9,901a
(407)398-199 Fl0r1ff2WteryE*N1c*.c*m
RECEIVED NOV 09.2015
TOO# ti6Z'011 6Z8898VU L .3uI `O2a72W 411,0 T0:8T STOZ/60/TT