HomeMy WebLinkAboutRoof Inspection Affidavit Public Works Department
Code Compliance Division
,iCOUNTY 2300 Virginia Avenue
• R I • A Fort Pierce, FL 34982
772-462-2172 Fax: 772-462-6443
INSPECTION AFFIDAVIT SEP
Re: Permit#(60 I - an
1
I,I OQJ �G'i licensed as a(n) ct * Engineer/Architect
(Please print name&circle license type) *F5468 Building Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or.about 1 ,J 0(-,91046 1 1 didersonall inspect the roof deck nailingand/or
N Y N
(Date) (circle those that apply)
ccam�;;
secondary water barrier 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.)
Signature and Seal License#
STATE OF FLORIDA -
COUNTY OF rF
Sw rn to and subscribed befor me this � day of ,f20 1� • ;
byerl 1 �}'K� � _. Who is person own t me orwho�has produced 'S".';* •
as identification.
a m�
Notary Public,State of Flood-5) 2 m
Signature of Notary: Cg W
Commission Number: U U*(Seal)
C�T=
En 09/17/09 ��'-2
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