HomeMy WebLinkAboutOwner Builder Affidavit J Planning& Development Services
�' M1 Building&Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982 j
772-462-2165 or 7721462-2172
Fax:772-462-6443 jI
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ROOF INSPECTION AFFIDAVIT
Re: Permit#
L (µdna A- licensed as a(n)Contractor,/Engineer/Architect
(Please print name&circle license ty *FS468 Building Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under468 F.S.to make such an inspection.
On or about `? '-�� , I did personally inspect the roof decklnailing
(Date)
work at:.
(Job site address)
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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
most strigent).
Signatur And Seal License
STATE OF FLORIDA
COUNTY OF FLORIDA
Swor to and subscribe bef a me this ,2-,�— day of 20� I.
by `C'�> MeZ-who is personally known to me or who has produced
as identification.
Notary Public,Sta orid
Signature of No
Commission Number: (Seal)
En 01/19/2011 ra`�;`:p;'e�%. "PEDRO M.ALONSO
* *MY COMMISSION N FF IM16
s .::EXPIRES:February 23;-2019
Bonded Thru Budget Notary Services
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