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<br />03/12/2008 07:51 FAX <br /> <br />~ 001/001 <br /> <br />180- oo~, <br /> <br />City of Zephyrhills <br />BUILDING DEPARTMENT <br /> <br />RE: Permit # 7 ~60 <br /> <br />9117107 <br /> <br />Inspection Affidavit <br /> <br />I J<, ViI'- \\..,~ <br />(plcuc print DIlDO ad circle Lie. Type) <br /> <br />,licensed as a(n) Contractor* IEngineerl Architect, <br />FS 468 Building Inspector* <br /> <br />License #; 0 r \ ~~sso> <br /> <br />On or about ~W~ ~:OO~ <br />(D8ID & time) <br />~nai~or.~_~"Od<Bl <br />_(A...II- ~ <br />~.yr":\\S J .J:1-. ~~S"4~ <br /> <br />, I did personally inspect the roof <br /> <br />Sl4S' $LA""n-w-h,'\\ It: , <br />(Joh Sia, Addrwll) <br /> <br />Based upon that examination I have determined the installation was done according to the <br />Hmricane Mitigation Retrofit Manual (Based on 553.844 F.S.) <br /> <br />~-L -" - <br />Si <br /> <br />STATE OF FLORIDA <br />COUNTY OF <br />Sworn to 7 ~'bed befmcme this KLday of /I'\I:1.Tdn <br />B~~~ -, . <br />Notary Public, State of Florida <br />~\...T'"~\n.-. ~ <br />(Print, type or stamp name) <br /> <br />.200~ <br /> <br /> <br />'IJ N_ry PullllC St.. 01 FlClI'Id. <br />'-... OlVlltl,n Rym." <br />;'c ,; MyCommilllo".DD7s1e1o <br />~tH"''' EIoIfftll112412012 <br /> <br />Personally known /" or <br />Produced IdentificatioD_ <br />Type of identification produced.. <br /> <br />.. Gallnl, BuilctiDg. Rellidemia1, or Roofing ConU1lQlOr or 110)' individual cenifi.d lDldcr 468 F .S. to make 5lId1au <br />inspectioD.lDclude photognphll of cech plene oflbe roofwith 1M pamit #I or lIddnlN #I clearly ebOWll marIced em the <br />deck far each iDspecIi~. <br /> <br />CnTnTn;J:lsion No.: <br />