HomeMy WebLinkAboutRoof Inspection Affidavit 06/21/16 08:33AM capps 7725464606 Page 1
Planning&Development Service
GAZEl Building&Code Regulation Division
2300 Virginia Avenue
a r Fort Pierce,FL 34982
772-462-2165 or 772-462-2172
Fox.,772-"2-W3
ROQFINSPEM— ON AFFIDAyfT_
Re; Permit i OQ
#, licensed as o(n)Contractor*/Engineer/Architect
(Please print name&cimA Ikense type) *FS468 Building lnspeew
*&nen;,6ug*g,Reskh:nao at Raanq Contractor or my l &Ahtof coed ur� F.1 r 468 to make such 0;nspect0m.
On or about � t tf i did personally inspect the roof deck naft
(nate)
work at: .L1.,r.1� � � t,w-`t `� r i }� t j -3
(lob site address)
Based upon that examination l 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 strlgent).
Signature and Seal License#
STATE C►F FLORIDA ,
cOUNrror_., i�
Svvorn to a r' bore me thlst�day of _20/
by Y � 5 who iS personally known to me or who has produced
as identification,
Notary Public,State of Florida f
signature of Notary:
Commission number: (Seat)
En W19/ZM2
ROI'FRAi1Kp"
MY coxs1ss►oai�
EXPIRES:lannarY{OU