HomeMy WebLinkAboutRoof Inspection Affidavit 1110912015 11:36 All Area Roof in T4772 464 6600 P.0011001
Jill Planning& Development Services
Building& Code Regulation Division
® 2300 Virginia Avenue
o
Fort Pierce, FL 34982
- 772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#1115A —.0M 1
I, O,YLLx ke-S QU O a ds , licensed as a(n)Contractor*/'Eingineer/Architect
(Please print name&circle license type) *FS468 Building Inspector
*General,Building,Residential or Roofing Contractor or any Individual certified under 468 F.S,�to make sl ch on inspection.
On or about , I did personally inspect the roof deck n filing
(Date)
work at: A0 S5 czlE'.5 a-
(job site address)
Based upon that examination I have determined the installation was done according to the current
edition of the Florida Existing Building Code Section 611 or the product approval submitted (whichever is
mos
�./ Signature and Seal License#
STATE OF FLORIDA
COUNTY OF
Swo to and subscri ed before me thisda of � 20L
by who i ersonall known o rwho has produced
as identification.
Notary Public,State of Florida ti�sirp�°
SONIA DESTAFN
A �;'� EY
Signature of Notary: s* fTs My COMMIMON#FF125420
Commission Number: (Seal) k'�,,�,, .o��+
W,,ed' o° EXPIRES May 21,2018
007)398 0153 Flo!1daNata Servlce•com
• En 01/19/2011 p}� � .
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