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<br />.JURliSDICTION,;OF YOUR ,CHOICE" <br />.BUIDD~G:DEPAR'fl\1ENT <br /> <br />RE: Permit# .'7/a3 . <br /> <br />9/17/07 <br /> <br />Inspection AffidaVit. <br /> <br />J J~ ~ I;\SS~ "'" <br /> <br />, (please print name and . Ie Lie. Type) <br /> <br />,licensed'as a(n) Contractor* /Engineer/Architect, <br />'FS 468 Building Inspector* <br /> <br />License #; {~~ I:;~ SS o.s- <br /> <br />On or. about <br /> <br />, I did personally inspect the roof <br /> <br /> <br />work at <br /> <br />38703 C~ ~ <br />(Job Site Address) <br /> <br />Z.~k7'- k: lA{ ,c;L <br /> <br />I <br /> <br />Based upon that examination I have detemiined the installation was done according to the <br />~OfitManual (Bas,ed on 553.844 F.S.) <br /> <br /> <br />Signature <br /> <br />STATE OF FLORIDA <br />COUNTY OF A J <br />Swom to and subscribed before me this ~ day of I va r)e--l ~ <br /> <br />By _I<~ui", 12,1~ ~ <br /> <br />.200d <br /> <br />I Notary Public, State of Florida <br /> <br />~ 2/ L- /~=t- <br />(Print, type or stamp name) <br /> <br />Personally known Lor <br />PToducedldentification <br />Type of identification produced. <br /> <br />C ., ~ AnnII MIIrie Lynch-Terry <br />OIDIDUSSIO . <br />! .. MY eu.,,,,~. f)D~1 <br /> <br />~Of.:I Expi,. AprIl 04, 2008 <br /> <br />~ Gen~, Building, Residential, or Roofing Contractor br any individual certified under 468 F.S. to make. such an <br />InSpection. Include photographs of each plane of the roofwith the permit # or address # clearly shoWIi marked on the <br />deck for each inspection. ' <br />