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n = A Building& Code Regulation Division
2300 Virginia Avenue
COUNTY Fort Pierce, FL 34982
772-462-2165 or 772-462-2172 RECEIVED
Fax: 772-462-6443
.SAN 17 2017
ROOF INSPECTION AFFIDAVIT PERMITTING
St. Lucie County, FL
Re: Permit# Z'701-6 S'3
I, /92�aN/ , 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 certified under 468 F.S.to make such an inspection.
On or about A/6�r -7 , I did personally inspect the roof deck nailing
(Date) Q l
work at: s�� -7ga"'V/L" f�1�� �7 �C✓�C�r�� y 2
(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
:0.�
Signature and Seal License#
STATE OF FLOR D
COUNTY OF
Sworn to and sub cribedl_before me this day of 20�7
by-`, ,{P�VIC� ]1�1'T(�jJ Who is personally known to me or who has produced
as identification.
Notary Pub' ate of Flori
Signature ,•``a:o�'•,, KAREN S. NIELSEN
Commission Number: I�
AFI P03�7 =r° Cgsolysion# FF 115637
_. �.;
do My Commission Expires
En 01/19/2011 June 12, 2018