HomeMy WebLinkAboutRoof Inspection Affidavit Planning& Development Services
"�r �� ° f� ; Building&Code Regulation Division
# UNTY 2300 Virginia Avenue
Fort Pierce, Fl.34982
772-462-2165 or 772-462-2172
- Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT C4 �n
Re: Permit# �Coag oLi G >
I, \ ter-" 0j1C_ , 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 468 F.S.to make such an inspection.
On or about UUU rJ I did personally inspect the roof deck nailing
(Date) SS
work at: �,J(, c
ob site address)
Based upon that examination I have determined the installation was done according to the current
dition the Florida Existing Building Code Section 611 or the product approval submitted (whichever is
m st str ent).
Signature and Seal License#
STATE OF FLORIDA,. -
COUNTY OF e.,
Sworn to and subscribed before me this 4 day of C 20
by Who is personally known to me or who has produced
as identification.
Notary Public,State of Florida
Signature of Notary:
Commission Number: (Seal)
En 01/19/2011
1 y-13 30a o l3 z `7