HomeMy WebLinkAboutRoof Inspection Affidavit 11118!2016 16:31 SEACOAST BANK WEST MORELAND ftX)772 337 6111 P.0011002
07/06/2012 09:52 7724625443 SLC INSPECTIONS PAGE 01/01
Planning&6evelopment Ser Vices
FF 7,
Building&Cade Regulation Division
23W Virginia Avenue
Fort Pierce,FL 34982
772-462 2165 or 772-462-2172
Fax. 772-462 .3
RQQF INSPEgION AFFIDAVIT
Re: Permit# ' 1
1, need as a(n)Contracto /Engineer/Architect
el
(PI else pri.t name&circle license type) or
*Genemv Building,Residentrol or RRoaAnu t:ontioctor or anYladividaal cereed under 405 FS,to make such an inspection,
On or about t �/ t t! .1 did personally inspect the roof deck naiiiniz
(date)
k
wor at.,'
(Job site address)
Based upon that examination 1 have determined the installation was done according to the Hurricane
Mitigation Retrofit Manual (Based on 553.844 F.S.)
Signature and Seal License#
STATE OF FLORI��
COUNTY OF
Sworn nd sulbscri d breFo me his Zt7_`5...✓
by . who1;�#1
meorwhohasp dua�d
as identiRce
,r�►�•• �,, JAIME ORTIZ
Rai Notary Pubiic.State of Florida
Notary Public,Ste t +•-1 My Comm.Expires Jun t,2018
Signature of Note '+",�oF � := C0mmi6810n a FF 1 t 1485
�1�ylP�� 8cnd"d Tttrou h Natlonaf Nolaty Assn.
Commission Number_
(Se 0
en 01/19/2011