HomeMy WebLinkAboutRoof Inspection Affidavit Planning& Development Services
............,
Building,&Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
ry 772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit
1, hlwzo license�f*FS468
ntractor*/E ineerjArchitect
(Please print n e&circle license type) uilding I ector
*General,Building,Residential or Roofing Contractor or any Individual certified under 468 F.S.to make such an inspection.
On or about _, I did personally inspect the roof deck nailing
(Date)
work at -&-'2
(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.)
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Sign Lure and4 ea9 I License#
STATE OF FLO D
COUNTY OF
Sworn o and subscribed before me this " day of20,11''
by Who Is personally known to 14e or who has produced
as identification.
Notary Public,State of Florida
Signature of Notary-
Commission Number: (Seal)
En 01/19/2011
DAVID VANDERFUER
i• •: MY COMMISSION#FFOGgsaa
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EXPIRES March 9,2018
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