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Roofing Permit Inspection Affidavit

2. Inspection Affidavit

4. I,

6. First Name

7. Last Name

9. licensed, as

10. professional title

    1. A contractor

    1. An Engineer/Architect, FS 468 Building Inspector

12. License No:

13. On or about

14. Date & Time inspected
    Date & Time inspected

    Date & Time inspected

16. I did personally inspect the

17. Check all that apply

    1. roof deck nailing
    2. secondary water barrier work

19. at

    Job site address

21. Being appropriately licensed to conduct this work, and based upon the examination of such work, I have determine that the installation was done according to the Hurricane Mitigation Manual (Based on 55.844 F.S.)

23. Signature

24. Date
    Date

Leave This Blank:


25. Print Only

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