HomeMy WebLinkAboutRoof Inspection Affidavit s n , r Public Works Department
Y k E � Code Compliance Division
COUNTY
2300 Virginia Avenue
• R I D A Fort Pierce, FL 34982
772-462-2172 Fax: 772-462-6443
INSPECTION AFFIDAVIT RECk'/Vio 4,11y
Re: Permit#
I, o-a-V xe"'-�a , licensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle license type) *F5468 Building Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
on or about 40ei'L , I did personally inspect the roof deck nailing and/or
(Date) (circle those that apply)
secondary water barrier work at:
(Job site address)
Based upon that examination I have determined the installation was done according to the
Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.)
y �-73 7
Signature and Seal License#
STATE OF FLORIDA
COUNTY OF Sk'.t-uc•�Q
Sworn to and subscribed before me this1�a _day of 20_K
by -c-ko L<uv-.6'C, Who is personally known to me or who has produced
L 0 L as identification.
Notary Public,StateQf Florida DEANNA GIVENS
Signature of Notary: Notary Public-State of Florida _
2' 'cxpires Dec 16,2016
Commission Number: E�5�1 1 -•_ 634y CommComm.
v` � Commission#EE 85876A
'q, Notary
ssn.
En 09/17/09 {, ;; Bonded Through National