HomeMy WebLinkAboutRoof Inspection Affidavit Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
d 772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#
licensed as a(n)Contractor*/Engineer/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 such an inspection.
On or about It - , I did personally inspect the r ofde k nailing
(Date)
z
work at: I
(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
most strigent).
Signature and Seal License#
STATE OF FLORIDA
COUNTY OF
Sworn to and subscribed before me this day of 20_&
by Who is personally known to me or who has produced
identification.
Notary Public,State of ja
Signature of Notary:
Commission Number: (Seal)
En 01/19/2011 +++++Il+rrr
otiPaYPua/�� SHREISS SCHWAB
,e Notary Public-State of Florida
^9 oa, Commission#FF 205427
My Comm.Expires Mar 32019
,