HomeMy WebLinkAboutInspection Docs 0610712016 15:17 TAR) P.0011001
Planning& Development Services
Building&Code Regulation Division
* 2300 Virginia Avenue
UNTY
` Fort pierce, FL 34982
772-462.2 .65 or 772-462-2 .72
Fax: 772-462-6443
R OF INSPEgION AFFIDAVIT
Re: Permit#_ia IGOS-O468
1, fic rm LaiTA._ , 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 I did personally inspect the roof deck nallina
(Date)
work at: —HO et" C,--
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of the Florida Existing Building Code Section 611 or the product approval submitted (whichever is
most strigent).
e n22ogM:
Signature and Seal License#
STATE OF FLORIDA
COUNTY OF fnaf�In
Sworn to and subscrloeed before me this day of \C%ylj . 20LC
by �CCI� _ LZ TA . Who is personally known to me or who has produced
as Identification.
Notary Public,State of F
Signature of Notary.-
Commission
otary:Commission Number: (Seal)
En 01/19/2011
THEAMAQERITA
MY COMMISSION#FF 0029
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E6 po►aher29,2017
Notary Pubit Ur*rwrlmre 1p16
RECEIV E�
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