HomeMy WebLinkAboutRoof Inspection Affidavit (2) 0412212016 07:28 ONSHORE ROOFING PPE IALIST (FAX) P.0011001
Planning& Development Services
Building&Code Regulation Division
_ .
2304�Virginia4Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax:772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# CS°a�C�,
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 4d8 F.S.to make such an inspection.
On or about.- , I did personally inspect the roof deck nailing
(Date)
work at: �'� t'J1'1�.3 �.
(lob site address} _
�i}�,P1(��a.ss 3'�l�j ,�.,,-'�5 ��;3 5 crD`i�.•5J
Based upon that examination I have determined the installation was done according to the current
edition th arida Existing Building Code Section 611 or the product approval submitted(whichever is
most strigen
ignature and Se License#
STATE OF FLO
COUNTY OF1�Z�`+
Sworn to and subs ribed before a this day ofR 206
by� �. Who onalTy"d—noe or who has produced
as id ation.
Notary Public,State i ida
Signature of Notary��
Commission Number: (Seal)
En 01/19/2011
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Sf{p,Elss SCHWA!
motary public-State of Florida }f
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commission.4 FF 2o5427 rq
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