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<br />~ cao~ <br /> <br />,City ofZeRJ!yrhills <br />BUILDING DEPARTMENT <br /> <br />RE: Permit # ~ <br /> <br />9/17/07 <br /> <br />Inspection Affidavit <br /> <br />I ~'1SW~"" <br /> <br />(please print name llnd circle Lic. Type) <br /> <br />.licensed as a(n~~/Enginee</Architect, <br />uilding Inspector* <br /> <br />License #; <:. c. ( 0 S-'17 S- Y") <br /> <br />On or about .3 - do 1 - Ocs. ~ ~ 00 P.1h . I did personally inspect the roof <br />~&rime) <br /> <br />deck nailin <br /> <br /> <br />work at b S" I C, f"'() ,'(... fY) (XJr , <br />(Job Site Address) <br /> <br />\)r-: -z... ~ f hyrh; Us I FL- <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 />~ ~ ~4'~ ~~ ------ <br />Signature <br /> <br />STATE OF FLORIDA <br />COUNTY OF s+ <br />Sworn to and subscribed before me this "2 1 day of --In CJ.. r C h <br /> <br />By \.~~{)it- ~ynt1" <br /> <br />~~K~ <br /> <br />.200~ <br /> <br />Notary Public, State of Florida. <br /> <br />~t~ (1110 Keo~ <br />(pnnt, type or stamp name) , <br /> <br />Personally known i or <br />Produced Identification <br />Type of identification produced. <br /> <br />Commission No_: <br /> <br />.. General, BuildiQg, Residential. or RoofiDg Contnctor or any individual certified under 468 F.S. to make such an <br />inspection. Include photographs of each plane of the roof with the permit # or address # clearly shown marked 011 the <br />declc: far caQb iDspecti~. <br /> <br />. ......~~..'" CORI ANN KEOUGH ~ <br />~m"~ \ Notary Pullllc . SIaII of FIoItda <br />· i. '~CommiSsionExplreaAUlI17, 2010 ~ <br />· \:, '!.7A! CommlI8Ion . DO 586503 · <br />· ~9f.:.~"- Bonded By National Nol8ry Aun. <br /> <br />~ - - <br />