HomeMy WebLinkAboutRoof Inspection Affidavit S.
Planning& Development Services
.._......... Building&Code Regulation Division n
2300 Virginia Avenue
Fort Pierce, FL 34982
„,,.,.,,,..,,........,..__.,._,.,.,,:,...,...............,,,�,,,,,.,,,,,:: 772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# 160Y—QY'2S�''
1, t licensed a a(n)Contractor*/ ngineer/Architect
(Please rint name circle license type) F spector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about I did personally inspect the roof deck nailing
(Da.92 pte�)y
work at: d /
(Job site address)
Based upon that examination 1 have determined the installation was done according to the Hurricane
Mitigation Retrofit Manual(Based on 553.844 F.S.)
&r�K cc__
S n ture an eal License#
STATE OF FLORIDA
COUNTY OFL
Sworn o and subscr d before me this _day of 20�
by Who is personally known t me or who has produced
as idenUlIcation.
Notary Public,State of Florida -
Signature of Notary:
Commission Number: (Seal)
En 01/19/2011 4
V,,' D"10 VANDERFLIER
MY COMMISSION#FFOMSO
EXP1pEs March 9,2010
(407)39a-utas F10rk1&No1a 9arvico.aom
TOO# £ZL'ON 6Z88S9YZLL 'OuI `Oza1eW <1720 80:8T 8TE/£0/S0