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.....,,,.,.,,,,,,,,:. Planning& Development Services
Building& Code Regulation Division
OO 2300 Virginia Avenue
a * Fort Pierce, FL 34982
772-462-2165 or 772-46272172
Fax:772-4626443
' I
ROOF INSPECTION AFFIDAVIT
i
/ z
Re: Permit# /7✓
I, z: 0 , licensed as n)Contractor /kngineer/Architect
(Please pri t name&circle license type) "FS46 ulldinge Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about I did personally inspect the roof deck nailing
(Date)
work at: ' c l 02,ze
(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.)
S4n tune an eal license#
STATE OF FLORIDA
COUNTY OF
Swor o and subscribed before me this ��� day of ?�7Y 24
by (i' Who is personally known tome or who has produced
_ as identification.
Notary Public,State of Florida
Signature of Notary;
Commission Number:
J
En 01/10/2011
DAVID VANDBpPLIER
MY CCMMiSSION#FF(moS5o
�.
EXPIRES March 9,2018 x
407 393-0153 FlorldaNatarySerkexom /v
RECEIVED OCT-- 212016 16
T00# 80Z'0H 82889 M LL 'oUI `0411ew 1AV-0 Z0:0Z 8TOZ/TZ/0T