HomeMy WebLinkAboutROOF INSPECTION AFFIDVAIT Public Works Department
Code Compliance Division
r
0 2300 Virginia Avenue
• Fort Pierce, FL 34982
772-462-2172 Fax: 772-462-6443
INSPECTION AFFIDAVIT
Re: Permit# 01C)47
GZ�4C4Jkl-- , licensed as a(�;o�natra(toI*s/Engine
er/Architect
(Please print name&circle license type) *F54nector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about 3y l m I did personally inspect the roof deck nailing and/or
(Date) (circle those that apply)
secondary water barrier 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.)
%, 33
Signature and Seal License#
STATE OF FLORIDA I A;1 ;•.
COUNTY OF
Savor to and subscribed before me this V day of 20�j -
by �3 arat -f i2LJ � Who is personaPon or who has produced �c g
as identification. m
Notary Public,State of Florida $` �
Signature of Notary: 4L l/ 23j
Commission Number: (Seal) A
a
En 09/17/09
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