HomeMy WebLinkAboutRoof Inspection Affidavit u�
e7/06/2012 09:52 7724626443 SLC INSPECTIONS PAGE 01/01
Planning&Development Services
Building&Code Regulation Division
I V-N*I .
t 23OD Virginia Avenue
Fort Pierce,FL 34992
772-462-2166 or 772-462-2172
Fax: 772-462-6443
fLQOF INSPEC17I4 AFFIDAVIT
Re: Permit#_r t6 '7-
licensed a ngineer/Architect
'-F-W8 ul din Inspector
(Please print name&circle license type) g P
*t;enemi,Building,Residentiol or Roofing Contractor or any individual certified under 468 F.S.to make such on inspection.
On or about I did personally inspect the roof deck nailing
(Date)
work at:
(,lob site address)
Based upon that examination I have determined the installation was done according to the Hurricane
Mitigation Retrofit Manual (Based on 553.844 F.S.)
6as-7�1,�
ature anffSeikal license#
STATE OF FLORIDA
COUNTY OF
Sworn to to and subscri ed before me this l� - day of 20�
by h1 ht i' �rL who s ersonally k e r who has produced
as identification.
Notary Public,State o v .A'',, JAIME ORTIZ
Signature of Nota NoWV PulBe.State at Florida
Commission Number My Comm.Expires Jun 1.2018
s Commissions FF 111485
En 01/19/2011 Niibnii Notary Asan.