HomeMy WebLinkAboutRoof Inspection Affidavit Planning & Development Services
Building& Code Regulation Division
• 2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit# I j +
I, =� iiJ �, 1�Ct;tdC � , 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 1 % Z3 ' , 1 did personally inspect the roof deck nailing
(Date)
work at: 6-10G i'c 10-u1,5 r'e, -qct—Y'fti
(Job site address)
Based upon th examination I have determined the installation was done according to the current
edition of t Flori xi ting Building Code Section 611 or the product approval submitted (whichever is
most str' nt).
Signature and Seal License #
STATE OF FLORI
COUNTY OF 1 °')'
Swo to and subscribed before me this day of %'� 20/7
'
h by J t 0 /4 ho is personal kn n o me or who has produced
/as identification.
Notary Public,State of Florid`% 1
Signature of Notary: /
r
Commission Number: (Seal)
En 01/19/2011
AUDREY B.HUMPHREY
MY COMMISSION# 6 2019
174772
EXPIRES:March 6, AUDREY B.HUMPHREY
`" Bonded Thru Nota Public Underwriters ;�o�."•'r"`'•"4:': p,1ISSI0N FF 174772
o, n " MEXPIRES.March 6,2019
a •�o`�`` 3e^ded Thru Nolary
Public Underwriters