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City of Zephyrhilis <br /> 5335 8et St <br /> Zephyrhills FL 33542 j <br /> (813)780-0020 <br /> ROOFING INSPECTION AFFIDAVIT <br /> Permit No.: lI� <br /> 1, I Gtt licensed under Chapter 468,Florida Statutes.as a(n): <br /> Contractor_Engineer_Architect=Building Inspector <br /> License No. 2..G 00 <br /> On or about did personally inspect the: <br /> Check: Roof Deck Nailing_LZDry in y Flashing and Drip edge <br /> Check which was used: 30#felt_Peel and Stick_Other(List} <br /> At the following , <br /> address: 3 ys T/1_GLLI S <br /> Based upon that examination,I have determined the installation.was done according to the Hurricane <br /> Mitigation Retrofit Manual(Based on Section 553.844,Florida Statutes), <br /> -Signature` c1 <br /> STATE OF FLORIDA <br /> COUNTY OF PASCO <br /> Sworn to � d subscribed b fore this day F'�u�`e— �• ` <br /> X <br /> t <br /> BY: <br /> —Z <br /> Notary Public State of Florida •- <br /> ,,, . CAROLYN CARLBERG <br /> ;# MY COMMISSION#GG W563 <br /> EXPIRES:December 9,2023 <br /> Banded Thor Notary Pubuc Underwriters ` <br /> r . <br /> is <br />