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<br />Ci:.~"'.. <br /> <br /> <br />JURISDICTION 'OF YOUR CHOICE <br />BUILDING DEPARTMENT <br />RE: Permit # 7'1}~ <br /> <br />9/17/07 <br /> <br />Inspection Affidavit <br /> <br />I 51.4tr ~~ciP'1.l(;t <br /> <br />(please print nlll1lC and circle Lie. Type) <br /> <br />,licensed a. a(~=ngin..r/ArChitecl, <br />Building Inspector'" <br /> <br />License #; C t (05)-7 f r 7 <br /> <br />On or about 1/2A 10 ~ 2; Jv PM . I did personally inspect the ro()f' <br />. (Date" time) <br /> <br />0ck ...it;,., and/or .<;:ndmv warer b~ork at 37127 t:=.x. I!!VN ...e l.- <br />(circle OM (Job Site Address) <br />~.~",=,yt,,'J1J r I J 3s- ~ L- <br /> <br />Based upon that examination I have determined the installation was done according to the <br />Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.) <br /> <br />~~ <br /> <br />Signature <br /> <br />STATE OF FLORIDA <br />COUNTY OF <br />Sworn to and subscribed before me this 29f4aay of <br /> <br />cJ4.-1'? <br /> <br />. 2003' <br /> <br />By S etJH- 'Bla..~ <br />~~.~ <br /> <br /> <br />Personally known K or <br />Produced Jdentification_ <br />Type of identification produced. <br /> <br />Commission No_: <br /> <br />. General. Building, Residential, or Roofing Contnwtor or an)' individual ccnilled under 468 F.S. to make such lI/I <br />inspection. Include pbot"g~s of cech plane "fthe roofwilh the JICmlit #/ or 1Id~ # clearly shown marked on the <br />deck for each inspection. <br /> <br />