HomeMy WebLinkAboutRoof Inspection Affidavit To: 17724626443 From: 17724928008 Date: 01/03/17 Time: 7:32 AM Page: 02/02
Planning& Development Services
Building& Code Regulation Division
2300 Virginia Avenue
f
n - Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#
1, A licensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle licens ,t) "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 a) I did personally inspect the roof deck nailing
(6
m�ate) `-
work at:
(lob 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 stri ent).
ignature and Seal License#
STATE OF FLORIDA
COUNTY OF-�-\- LUPI
Sworn to ands scribed before me this� _day of�gV qC1•_20
by rn, Who is aer` sonally known to me orwho has produced
as identification.
Notary Public,State of Florida
Signature of Notary:
Commission Number: ) KELLY 9 BAILEY
En 01/19/2011 `. M'CONWISSION#FF936448
EXPIRES November 16,2019
1a071399-0'33 .�
CENV D
JAN o 2017