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<br />.JlJRfSDICTlON,OF YOUR>CHOICE <br />, '.BUThD~GDEPARTMENT <br /> <br />RE: Permit# ,3LPL 9n7107 <br /> <br />'lnsDectiOD AffidaVit <br /> <br />.I-Rt'J~ l!-_ ~~. ,license(tas a(n) Contmctor* /Engineer/Architect, <br />(p1c:aseprintJlllllleandcUdeLic. Type) 'FS 468 Building Inspector* <br /> <br />On or-about <br /> <br />Cc-c i3~F:;Y'19 <br />-:.j)f1v . ~ 0 ,g- <br /> <br />License #; <br /> <br /> <br /> <br />I did pen;onally inspect1he rt <br /> <br />"er wmk at fe 0 'f s-:- (7 it <br />Qob Site Addn:ss) <br /> <br /> <br />hayeOOtf'!l'mined'the installation was done according to the <br />(Based on 553.844 F.S.) <br /> <br />STAlE OF FLORIDA <br />COUNTY OF -JfA' '4 <br /> <br />:om~~~day~f ~~U4'7 <br /> <br />. ' Notmy Public, State of Florida <br />1 C'1 v' J\ <br />L-,{t~U' c U/XtH <br />(Print, type or s1amp name) <br /> <br />.200~ <br /> <br />Personally known ~ <br />Produced Identification <br />Type of identification produced. <br /> <br />Cnnnnl~sionNo. "0'"'"0,,,'0 LESLIE DIXON <br />.~ MY (0\1\115510'i ~ DI))73386 <br />'~";''f::J;'_\c/}' f.'XPH<ES: July 12. ~OIO <br />i-'<Ii<\-:-~,ur,\.f<.Y ri i\,'_'I3I;' Di-.~C<.)\l!lt A'>s.:oe, C0. <br />~ <br /> <br />-: ~ Building, ~a1, or R.oofiDg Con:Iracmr ~ any individual certified UDdc:r 468 FoS. tD make. such an <br />mspcction. 1DchJde photographs of each pl.aDe oftbe roofwith the permit '# or lIddress '# cIc:arly sbowJi 'IIJIIdtaf on the <br />deck: for each inspection. . <br />