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o Fort Pierce,FL 34982
.; 772-462-2165 or.772-462-2172
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ROOF 1NSPECTIONAMDAVIT
Re: Permit 0 0(5 ' 0515i0
I, licensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle.licens e) *FS468 Building Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 FS to:mgke-such an inspection.
on or about LD' - 1k .;f did personally"inspectth,e roof deck,na lin>;
(Date)
work at:M(4 a(�1�( n a
U (lob 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 produc 'apprbval submitted (whichever is
most strigent)
I P )- / CC r_..l 33 o.Qov
Signature and al License
STATE OF FLORID
COUNTY OF `\
SwQrn,,to a j ubscrib d`before.me this Vh. 20L
by Uc'e MINIUM Who is„<personally known to m r who'hasproduced
as identi cation.
Notary Public,State of Florida
Signature of Notary:
Commission Number: (Seal)
En 01/19/2011
2�` SONIi4°DESTAFNEY
Q-..MYCOMM SIGN#MF 5420
0
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