HomeMy WebLinkAboutRoad Impact Fees 01/1612017 15:07 All Area Roofing TAX)772 464 6600 P.0.01/001 _.
i h Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, Fl.34982
77Z-462-2165 or 772-462-2172
. K
Fax: 772-462-6443
- ROOF INSPECTION AFFIDAVIT
Re: Permit##!/`n/ 0094
1, u, ��E-'� CC r . licensed as a(n)Contractor*/Engineer/Architect
(Please print-pame&circle license type) *FS468 Building Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468 F.S.to make such an lnspectlon_
On or about /� /�I , 1 did personally inspect the roof deck naEM
(Date)
workat: 7' �J ��'s�_�(_Y_ 1 '�� bAt'I.rGc
(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 t ent�. _
Signature and Seal License#
STATE OF FLORIDA
COUNTYOF
Swoun-to and subscril d before me this day of 20A
by.C!Na ✓rte P°�Q1L7, 15, . Who 15 personal) known to me�orwho has produced
as identification.
Notary Public,State of Florid
Signature of Notary: Z7^--�
Commission Number: (Seal)
9n Q1/19/2011
�'�A„aero FAITH MASON
x * MYCOMMISSI010613003939
. y, � gW9tES:auea 20,2ta20
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