HomeMy WebLinkAboutInspection Docs Public Works Department
Code Compliance Division
2300 Virginia Avenue
• Fort Pierce, FL 34982
772-462-2172 Fax: 772-462-6443
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INSPECTION AFFIDAVIT
Re: Permit#
licensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle license type) *FS468 Building Inspector
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*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S..to make such an inspection.
On or about Q6L6 , I did personally inspect the roof deck'nailing and/or
(Date) (circle those that apply)
secondary water barrier work at:
(Job site address)
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Based upon that examination I have determined the installation was done according to the
Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.)
a �9 �
ignature and Seal License#
STATE OF FLORI A i
COUNTY OF
Sw° to and subs 'bed before me this 20I�
by W ersonally known a or who has produced
as dentification.
Notary Public,State of Florid
Signature of Notary:
Commission Number: (Sea'
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En 09/17/09
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HUFFk tary Public
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