HomeMy WebLinkAboutRoof Inspection Affidavit Planning&Development Services
g,La Building&Code Regulation Division
2300 Virginia Avenue
. Fort Pierce,FL 34982
772-462-2165 or 772,462-2172
Fax:772.462-6443
ROOF INSPMIQN AFFWAVIT
`60
Re;'Permltt#-,1Q.— Oil If 0
licensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle license type) *FS468 Building inspector
*General,Building,Residential or Roofing Contractor or any Individual terrified under 466 F.S.to make such an inspection.
On or about I did personally inspect the roof deck na),lna
(Dat }
work at: 0 A
(Job site address)
Based upon that examination I have determined the Installation was done according to the current
edition of the Florida Existing Building Code Section 611 or the product approval submitted(whichever is
most strigent).
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Sign&4 miQAeal License#
STATE OF FLORi A
COUNTY OF 61
Sw sand s scr a before m this__ __ nonally
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bV Who i wn me or who has produced
as(dent
Notary Public,State of Florld N�I�i{iNrt�'�
Signature of NotaryF3AUN/rp'��
commission Number: (seal) ��`� `r��' \BSIpN !;
En 01/19/2011 a 9N
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JIFF 122434
RECEUVED
JAN: 3 2017