HomeMy WebLinkAboutInspection Docs From:Richard Newland� Fax:(866)610-8652 To: Fax.: +1 (772)4626443 "q 3 of 3 0611412016 11:57 AM
Planning& Development Services
T' J l .yit av '.s°3 G i�.Y.;�'
Building&Code Regulation Division
2300 Virginia Avenue
D _ Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# ) 06-
t� 9
{ (2
GAJ licensed as a(n)Contractor*/Engineer/Architect
(Pleas4 print name&circle license type) *FS468 Building Inspector
General,Building,Residential or Roofing Contractor or any individual certified under 468 F5.to makesudr an inspection.
On or about b- i � /6 , I did personally inspect the roof deck nailing
(Date)
r�
work at:
(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).
�- Signature and Seal License#
STATE OF FLORIDA r�
COUNTY OF 57-1-16,t-/f
Sworn to and subscribed before this /, day of --�LL yz f' 204
by C.%L Li✓ A'A � to SOLtIo i�s ` to me or who has produced
as identification.
Notary Public,State of Florida c, -�a.•�.�„ �^
Signature of Notary: w��p�� MISW80mliv
Commission Number: (Seal) f~ " MYcOMki1&5P0N#EE863700
3 fr{FIRES:°
y�AkR 13,2017
En 01/19/2011 €_ �BanDwtf .:ir,� h istS;=t,Jnsurance
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