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<br />,JURfSDICTION,iOF YOUR ,CHOICE <br />, ',BUlLD~GDEPAR[1\ffiNT <br /> <br />RE:Permit# 73 '1 ~ 9/17/07 <br /> <br />'Inspection AffidaVit' <br /> <br />.I <br /> <br />Leo"lR.' N4.l.L If , <br /> <br />,licensed'as a( <br /> <br /> <br />(please print name and circle Lie. Type) <br /> <br />License #; C C ( 0 '-{ ~r3 7 0 <br />On or'about loJ .;;U - 07 ' I: 30 fJA1 , I did personally inspect the roof <br /> <br />(Date & time) <br /> <br />60+4 <br /> <br /> <br />water barrier <br /> <br />ork at S? 5' I ;::;, ,.. -c: sf.- L'.(I'1"(, <br />(Job Site Address) <br /> <br />'. t:'L-. 33S'#37 <br /> <br />STATE OF FLORIDA <br />COUNTY OF <br />Sworn to and subs . <br /> <br /> <br />me this :20 day of 00'-c/n()c-'- <br /> <br />.2002 <br /> <br />By <br /> <br />, Notary Public, State of Florida <br /> <br />Personally known _ or <br />Produced Identification <br />Type of identification produced. <br /> <br /> <br />, e ~TERLING <br />. : MY COMMISSION # 00727020 <br />'ion~~~~~ :jB}b <br />91-0153 F <br /> <br />r\) i./ 3Q- 5 3~ - S-~.- 33)- v <br /> <br />~ Gen~, Building, Residential, or Roofing Contractor ~r any individnal certified under 468 F .S. to ~ such an <br />mspection. Include photographs of each plane of the roof with the pemrit # or address # clearly shown marked on the <br />deck for each inspection. ' <br />