HomeMy WebLinkAboutRoof Inspection Affidavit I
Planning & Development Services
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Building&Cade Regulation Division
O 2300 Virginia Avenue
Fort Pierce, Fi.34982
�y 2 772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#-k(f 1603 - Q36 Z
1, licensed as a(nContracto /Engineer/Architect
(Please print name&circle license type) *FS468 Bui ing Inspector
'General,Building,Residential or Roofing Contractor or any individual certified under468 F.S.to make such on inspection,
On or about Z2 l.(� I did personally inspect the roof deck nailing
(Date)
work at: ao5 N a2 -( e-e Doul., - R, PlEw'e
(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 stcigept).
�711S'iignatur/land Seal License#
STATE OF FLORIDA
COUNTY OF� _«(�
Sworn to and subscribed before me this day of MAO 20_( t
by . Who is personally known to me or who has produced
jAJ 'a.t ' as identification.
Notary Public,State ida^
Signature of Not �,jdl�'"
Commission N be . �� 14 (Seal)
En 01/19/2011
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sy ires
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