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Building - Roofing Inspection Affidavit

  1. I am licensed as a(n)*

  2. and did personally inspect the roof deck nailing and secondary water barrier work at

  3. Enter mm/dd/yyyy and time

  4. Based upon that examination, I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.).

    Signature________________________________________ License#____________________________________

  5. The forgoing authorization letter was acknowledged before me this ___________ day of ________, 20____by____________________________


    ___who is personally known to me
    ___who has produced identification_________________________________________


    Notary Public Signature:______________________________________

    My Commission Expires ______________________________________

  6. *General, Building, Residential, or Roofing Contractor or any individual certified under 489 F .S. to make such an inspection.

  7. Please be advised this form is for customer use only. Building Services will not track, monitor or receive a copy of this request. Enter a valid email below to receive a copy for your processing.

  8. Leave This Blank:

  9. This field is not part of the form submission.