HomeMy WebLinkAboutRoof Inspection Affidavit m� ....-._..__._._.. _ _ Planning& Development Services
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Building&Code Regulation Division
2300 Virginia Avenue
Fart Pierce, FL 34982
�......,.,..,.., 772-462-2165 or 772-462-2172
Fax., 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#
I, f� licensed as a(CContrac;tngineer/Architect
(Please print n me&c' cle license type) *FSng Inspector
*Generol,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about 1 did personally inspect the roof deck nailing
(Date)
l �oo
work at:
(job sil.e address)
Based upon that examination I have determined the installation was done according to the Hurricane
Mitigation Retrofit Manual (Based on 553.544 F.S.)
S n tureanc Jeal License#
STATE OF FLORi A '
COUNTY OF /`) /
Sworn to and subscribed before me this _Lam' day of cel 2o�
by - alz�/171C(/ Who ispersonally known to me or who has produced
as identification.
Notary Public State of Florida
Signature of Notary; RECEIVED
Commission Number: (Seal)
En 01/19/2011 a'isir► ti
DAVID VANDERFLIER
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