HomeMy WebLinkAboutRoof Inspection Affidavit Planning&Development Services
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Building&Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
................. 772-462-2165 or 772-462-2172
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Fax:772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#
61-C{w' licensed as a(n)Contractor*/Engineer/Architect
(Please print n &circle license type) *FS468 Building inspector
*General,Building,Residential orRoofing 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:
(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.)
Sign ture an8,Jeal License#
STATE OFFLORI'A,
COUNTY OF
Sworn t"nd subscribed before me this day of qe�Ivl — 2 0
by Who is personally known Leme or who has produced
as Identilication
Notary Public,State of Florida
Signature of Notary:
Commission Number: (Sea[)
Fn 01/19/2011
D"10 VA14DERFLIER
d.3 MY COMMISSION#FF:099560
EXPIRES March 9,20a
(407)39"153 Fla r1dallolary9erviCe,gom
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