HomeMy WebLinkAboutInspection Docs (2) Planning & Development Services
Y= v `. k... h ` Building & Code Regulation Division
2300 Virginia Avenue
UM,I:s Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
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ROOF INSPECTION AFFIDAVIT
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I, 5� �c5� �t�dS`� \ , licensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle license type) *FS468 Building Inspector
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*General„Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or abour�, \,l \�_ �o\� , I did personally inspect the roof deck nailing
(Date)
work at. V -
(Job site address)
Base t hat examination I have determined the installation was done according to the current
editi'St
of th ,.Florida Existing Building Code Section 611 or the product approval submitted (whichever is
most I ent). -
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Signature an Seal License#
STATE OF FL RIDA
COUNTY0F� 1J
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Swor o and sub cribed before me this ��-� da o ��?L1 20_0
by C C�NC5\C\ . Who is rsonally om or who has produced
as identification.
Notary Public,State of Flor a
Signature of Notary-
Commission Number: (Seal)
En 01/19/2011
♦ CP,Y'PueliL
a SHREISS SCHWA
;_° °: Notary Public-State of Florida
Commission ik FF 205427
,q� o4;r� my Comm.Expires mar 3,2019
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