HomeMy WebLinkAboutRoof Inspection Affidavit Planning&Development Services
tl Division
Building&Code Regulation
�. 2300 Virginia Avenue
m Fort Pierce, FL 34982
r
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# A
1, ' G� , licensed as a( Contractor* Engineer/Architect
(Please print na e&circle license type) ' "FS Inspector
*General,13vilding,Resldentl9l or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about /P , 1 did personally inspect the roof deck nailing
(Date) / ,Q
workat: u a/'
(Job 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.)
a. n r
Q.31►,n.,i t�, CC.- Co 6 5115-0
Sign'ture a4deal License#
STATE OF FLORIDA
COUNTY OF
r PSworn to and subscribed before me this�c _day of ZO_Z
by 622z:?/_ Who is personally known to 4e or who has produced
_ as identification.
Notary Public,State of Florida
signature of Notary:
Commission Number: (Seal)
Fn 01/19/2011 4
DAVID VANDERFLIER
MY COMMISSION#FF099560
�7'rd�rrf EXPIRES March S 2018
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