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Building&Code Regulation ivi i
2300 Virginia Avenue
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Fort Pierce, FL 34982
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Fax. 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#_
licensed as ,Contra ' r*`/Engineer/Architect
(Please print Varne&circle license type) *F5468 Building Inspector
*Ger?71 Building,Res'dent'al or
Roofing contractor or ony individual certlfed under 468 F.S.to make such an inspection.
on or about f"31 , I did personally inspect the roof deck nailing
(Date)
work at: la(9
(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.)
9•l , I�C r CSU 46 Z/ /
Sign ture anc eal License#
STA7F OF FLORIDA
CQUNTY OF
Sworn and subscrl ed before me this day of 20
by `)G !'' Who is personally k own to mWe orwho has producecJ�'VED APR .2 20S
as iderAiricalion. T REC
Notatl`y Public,State of Florida
Signature of Notary:
Commission Number: _ (Seal)
En 01)7.9/2oxx pAY1D ER
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