HomeMy WebLinkAboutRoof Inspection Affidavit Planning& Development Services
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Building&Cade Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
............................................................. 772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: PeAa��
mit# .3
I, !" licensed as a )Contractor*/ gineer/Architect
(Please prin name&circle license type) *FS pector
*General,Building Residential ar Raafing Contractor or anyindivldual certified under468 F.S.to make such an inspectlon.
On or about 9 9�'.� jo , 1 did personally inspect the roof deck nailing
(Date)
work at: �2. �( LG I��-.
(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.)
Slgn ture and eal License#
STATE OF FLORI
COUNTY OF
Swor, o and sub 'bed before me this day of 20,,Z(�
by who Is personally known to4c or who has produced
as identification.
Notary Public,State of Florida
Signature of Notary: W,
Commission Number: O f (Seal)
En 01/19/2011 DAVID VANDERFLIER
MY COMMISSION#FF099560
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EXPIRES March®,201A
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2016
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