Laserfiche WebLink
<br />City of Zephyr hills <br />BUILDING DEPARTMENT <br /> <br />RE: Permit # 7__)flVr <br /> <br />9/17/07 <br /> <br />Inspection Affidavit <br /> <br />I <br /> <br />~t/?.- <br /> <br />i? /J //.)// <br /> <br />~-~ <br />,licensed as a(n ontractor*' ngin~ Architect, <br /> <br />~InSP~ <br /> <br />(please print name and circle Lie. Type) <br /> <br />License #; .-f! C () {) 5I6;Z L) J <br />-2~5hY <br /> <br />/ ,(Date & time) <br /> <br />~ and/or secondarv water barr!!!!: lvork at 0 c; 72- t1 L6J.//t4/'7) o() <br />(dll;i"" .mO) (Job Site Address) <br /> <br />On or about <br /> <br />, I did personally inspect the roof <br /> <br />Based upon that examination I have determined the installation was done according to the <br />Hurrican 'tigation Retrofit Manual (Based on 553.844 F.S,) <br />/7 to <br />~ <br /> <br /> <br />Signature <br /> <br />STATE OF FLPJUDA <br />COUNTY OF ffi sea , . <br />Sworn to and subscribed before me this JJfb..... day of <br /> <br />By R i (I( ~ Y (} Q V j N <br /> <br />JUNe... <br /> <br />.200~ <br /> <br />Notary Public, State of Florida <br /> <br />eax~l:J~ ~ <br />(print, type or stamp name) <br /> <br />Personally known V or <br />Produced Identification <br />Type of identification produced. <br /> <br />Commission No.: <br /> <br /> <br />CAROl. YN DRISKELL <br /># DO 728829 <br />~. ii,.i EXPIRES: November 20, 2011 <br />~iff..r..~,. Bonded Thru Notary Public UndelWl1lera <br /> <br />* General, Building, Residential, or Roofing Contractor or any individual certified under 468 F.So to make such an <br />inspection. Include photographs of each plane of the roof with the pennit # or address # clearly shown marked on the <br />deck for each inspection. <br />