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From:Richard Newland Fax:(866)610-8652 To:St Lucie Inspections Fax: (772)462-6443 Page 2 of 2 12/27/2016 8:31 AM
Planning&Development Services
Building& Code Regulation Division
2310 Virginia Avenue
y Fort Pierce,FL 34982
a :a r-
772-462-2165 or 772-462-2172
Fax:772-462.-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#l�
I,_ t �r`iC,r-(.,
rl __ ►l�� G'- v4 licensed as a ontr gineerjArchitect
(Please print name&circle license type) "FS' uilding Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an inspection.
On or about u ' ,I did personally inspect the roof deck nailing
(Date)
j
work at: *' ✓'t ri ` f�` G
(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.)
X 57(!5 C'.1 �, /
Signature and Seal License#
STATE.OF FLORIDA,
COUNTY OF ii t t c
Sworn to and subscrib d before 9ne this day of ,' r cc- t 20
by i c.L L d f�t'++1(P.- - U -i�r€atTt i� a&who has produced
as identification.
Notary Public,State of Flgrida
Signature of Notary:'1`
Commission Number: r 0 (Seat)
En 01119/2011 -�-- --�„
M► MISTYBOBILIN )
MYC0UfAISSI0N„EE883700
EXPIRES.MAR 13.2017
"° 80AW through ist State Insurance
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