HomeMy WebLinkAboutRoof Inspection Affidavit I'
Planning& Development Services
Building&Code Regulation Division
® 2300 Virginia Avenue
Fort Pierce, FL 34982 ;'1
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772-462-2165 or 772-462-2172
Fax: 772-462-6443
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ROOF INSPECTION AFFIDAVIT
Re: Permit#sz C
licensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle license type) FS468 Building Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 458 F.S.to make such an inspection.
On or about �P" , I did personally inspect the roof deck nailing
(Date)
workat: 7g6 / �� �!/"4, cT
(Job site address)
Based upon that examination I have determined the installation was done according to the Hurricane
Mitigation Retrofit Manual (Based o 53.844 F.S.)
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Si Ature and Seal License# l'
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STATE OF FLORIDA,,,7
COUNTY OF
Sworn tond subscribed before me this day of�g I-is 20��
Qby 8 G'(�S11c�mc�a� Who is personally known to me or who has produced;
el, 110/ as identification.
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Notary Public,State of Flori
Signature of
Commission Numbe (Seal)
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En 01/19/2011 Op NRPB
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