HomeMy WebLinkAboutRoof Inspection Affidavit ` � 1
Public Works Department
., . . r Code Compliance Division
COUNTY 2300 Virginia Avenue
• R I D A Fort Pierce; FL 34982 .
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772-462-2172 Fax: 772-462-6443
INSPECTION AFFIDAVIT
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Re: Permit#
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licensed as a(n)Contractor*/Engineer/Architect
(Please prirA 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 I did personally inspect the roof deck nailing and/or
(Date) (circle those that apply)
secondary water barrier work at: ��� (0 9-\ ��Q fl.Q:�"t D rc) k.
(Job site address)
Based upon that examination I have determined the installation was done according to the
Hurricane Miti ion Retrofit Manual (Based on 553.844 F.S.)
CGc /3,2 �2�
g ture and Seal License#
STATE OF FLORIDA
COUNTY OF5k-1►U t \
Sworn to and subscribed before me this (0 day of N C)-� 20�
by L. oN� C . Who is personally known to me or who has produced
F L ID as identification.
Notary Public,Stat IVENS
Florida .4 .;;{ ,. DEAN� IE gG022023.
;a� MY COMMISSION#
Signature of Notary - -, �(pIRES:Decembe�16 X20
Commission Number:
dtarypublkUnderwdters
;,�ddi�oa: geode
En 09/17/09