HomeMy WebLinkAboutRoof Inspection Affidavit •i,
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Planning& Development Services
Cal
Building&Code Regulation Division
2300 Virginia Avenue I'
® Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443 i h
ROOF INSPECTION AFFIDAVIT I,
Re: Permit#
I, er�Z, I� licensed as a(n)Contractor*/Engineer/Architect
(Pleas print name&circle license type) *FS468 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 a (� I did personally inspect the roof decklnailinl;
(Date)
work at: 17 IV r-e5�Q
(Job site address)
I ' I
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 strig nt). '�
C( C it 3 ff
Signature and S I License#
I
STATE OF FLORIDA II i
COUNTY OF Sr Ly C f
Sworn�t�o and subscribed before me this day of (Jo� 20
by.C�C1�Ci c L lQ an Who is personally known to me or who has produced { I
as identification.
Notary Public,S E l i a
Signature of tary: j
Commission r: (Seal)
I
En 01/19/2011
oa. •,LASH AHNA INGRAM
2"* Notary Public-State of Florida
w « MY Comm.Expires Dec 20,2018
%rE• Commission#FF 177249
i'� Bonded through National Notary Assn.I