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<br />.roRTSDICTION.iOF' YOUR ,CHOICE. <br />. . :BUIT.tDING'~EPAR'ifMENT <br />iJ ~6L' "I" . , ..", <br />~.~- . '., ' <br />RE: rermit# _ , , " 9117/07 <br /> <br />1nsJiection AffidaVit' <br /> <br />J . ~,'ct.~yd 'hv-k cfI <br /> <br />(please print name and circle Lie. Type) <br /> <br />,li~as a(n) ~ /Engineer/Architect; <br />, '68 Building Inspector <br /> <br />License #; <br /> <br />'c eG',3 2-5f99 <br /> <br />On or-about <br /> <br />(Date & time) <br /> <br />. . <br /> <br />de~k nailinf!andlor secondarv ~at~ barri~ work at <br /> <br />1-ef'1!";li1s .:;L . 3 3 SlfL- <br /> <br />, I did personally inspectthe roof' <br /> <br />3e~ 2D (1ed/'YlttYtV- fke-, <br /> <br />(Job Site Address)' <br /> <br /> <br />, <br /> <br />tion I have detem1med the installation was done according to the <br />'onR~tro ased on 553.844 F.S.) <br /> <br />STATE OF FLORIDA <br />COUNTY OF <br />Sworn to and subscIibed before me this 2Y day, of <br /> <br />By ,W~eil>f&:;~\ <br /> <br />Jl1l/1e <br /> <br />.20rfl <br /> <br />I Notary Public, State of Florida <br /> <br />, "p'~~'fp'~. JACQUELINE SOGES <br />. ~t~Ji~~01O <br />. ,...:t',RI.:%'" _TllIllTrayFoIlI_80Q0386-7019 <br />Commission No.: <br /> <br />Personally known -1:-- or <br />Produced Identification <br />Type of identification produced. <br /> <br />~ Gen~, Building, Residential, or Roofing Contractor 6r my individual certified undc:r 468 F.S. to make such an <br />mspcc1ion. In~lude p~otographs of each plane oftbe roofwitb the pcIIDit # or address # clearly shoWli:marked on the <br />deck for each mspcc1ion. . <br /> <br />! ' <br />