HomeMy WebLinkAboutRoof Affidavit Planning& Development Services
l; Building&Code Regulation Division
2300 Virginia Avenue
Fort Fierce,F4 34982
772-4622165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re. Permit
licensed as (n)Contractor* • ngineer/Architect
(Please pr' t name circle license type) 468 Build' nspector
"Gpneral,Building,Resident) I orRoaf ng Contractor or ony individual certifled under 468 F.S.to make such an inspection.
On or about / 1 I did personally inspect the roof deck nailing
(Da e}
work at: �� � if. / 6,
(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.)
00 6-
Sin tune an"eal License#
STATE OF FLORIDA
COUNTY OF �
Swor to and subscribed before me this 21 day of 20
by _ Who is personallykno�to me or who has produced
as identification.
Notary Public,State of Florida
Signature of Notaty:
Commission Number: (seal)
En 01/19/2011
DAVID VANDERFLIER
MY co
MMISSION#F170991530
EXPIRES March 8,20113
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