HomeMy WebLinkAboutInspection Docs Public Works Department
r Code Compliance Division
COUNTY 2300 Virginia Avenue
• A Fort Pierce, FL 34982
772-462-2172 Fax: 772-462-6443
INSPECTION AFFIDAVIT
Re: Permit#16
I, M (45V' licensed as
( on 'ror*/Engine
er/Architect
t ame& e license type) *Please r F8in Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
on or about cJ ��'-/ I did personally inspect the roof deck nailing and/or
(Date) (circle tho a that apply)
secondar water barrier work at:� 0
v
(Job site address) /�al``
Based upon that examination I have determined the installation was done according to the
Huirricane Mitigation Retrofit Manual (Based on 553.844 F.S.)
CC C O5 7z:
Sign tur an Seal License#
STATE OF FLORIDA
COUNTY OF
Sworn to and subscribed before me this— 1 day of 20'
by- Q Q i2Who is persona known-p me or who has produced
as identification.
Notary Public,State of Florid
Signature of Notary:
Commission Number: (Seal)
En 09/17/09 ""
AUDREYB.H:FF
y
+= MY COMMISSION772
EXPIRES:Mar9
Thru NoY Puwriters