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Building&Code Regulation Division
2300 Virginia Avenue
{ Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
M , F Fax: 772-462-6443 F
ROOF INSPECTION AFFIDAVIT SEP 19'2016
C4
Re: Permit# ��` ` BY.
, licensed as a(n onr */Engine
ct
er/Architect
Please tint name&circle license type) BuFS468 i in Inspector
*General,Building,Residential or oo in Contrado r-any individual certified under 468 F.S.to make such an inspection.
On or about 1 did personally inspect the roof deck nailing
(Date)
work at: a � f.4,q
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of the Florida Existing Building Code Section 611 or the product approval submitted (whichever is
most strigent).
Signature and Seal License#
STATE OF FLORIDA
COUNTY'OF 4rr1/11 V/V/ r,,,,
Sworn to and subscribed before this day of Jam"/ M,6112, 20
by Gr/)4y--M-`4, 4;k7
. Who is p rsonally known to me or who has produced
k aO as identifi ation.
Notary Public,State of Florida — /
Signature of Notary: ✓" ��`�
Commission.Number:
En 01/19/2011
S O S