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O
yWN NO Building&Code Regulation Division
& UNTY 23M Virginia Avenue
Fort Pierce,FL 34982
772-462-2165 or 772-462-2372
Fax:772442-6443
MF INSPECTION AFFIDAVCI`
Re: Permit# l -171
I, ri' a / licensed as ai( Contract r* Engineer/Architect
(Please print name&circle iicen type) *FSa6A Bu g Inspector
*Gsnertn,Bulldlnp,ROIddtatio��l orRoq(lnp Contractor or any Individual cert$ed under 468 F.S.to make such an inspection.
On or about 1C�Gl s< . I did personally inspect the roof desk n8ilintt
(Pate)
work at• 1 ' C ,(fir
(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 fill or the product approval submitted(whichever is
most strigent).
Signit—ur&MT9Qal License#
STATE OF FLORIDA
COUNTY OF 5±
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Notary Public,State of Florida
Signature of Notary;
Commission Number: A�`, � ,� r���
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En 01/19/2011
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