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<br />City of ZeJiliyrhills <br />BUILDING DEPARTMENT <br />RE: Permit # 77'-11 <br /> <br />9117/07 <br /> <br />Inspection Affidavit <br /> <br />I ScoH-(jlC4-~Y\ <br /> <br />(please print name and circle Lie, Type) <br /> <br />,licensed as a(n)~~gineer/An:bitec~ <br />Building Inspecto~ <br /> <br />License #;C ceo ~ 7 7 .s- 1 <br /> <br />On or about 5/2JOeY , I did personally inspect the roof' <br />(Date & time) <br /> <br />~ailinf and/or secondary water ba;;-;;Jwork at Co LO~ /-fUh f1 ~ Ion {)K, <br />(circle one) (Job SIte Add~9) <br /> <br />,- 2(f~'1rh,'l L~ I EJ Q Y \'ol, <br /> <br />Based upon that examination I have detemrined the installation was done according to the <br />Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.) <br /> <br />~~~ <br />Signature <br /> <br />STATE OF FLORIDA <br />COUNTY OF ,.) .J1j <br />Sworn t~ and subscribed before me this Lday of a...j <br /> <br />By G(O it !31'i L~ YvltA-V\ . <br />Notary Public, State of Florida. <br /> <br />{i~' a-...... ~ <br />(Print, type or stamp name) <br /> <br />.200% <br /> <br />,j-.... <br /> <br />Personally knownL or <br />Produced Identification_ <br />Type of identification produced. <br /> <br />Commission No.: <br /> <br />.. General, Building, Residential. or Roofing Contractor or any individual certified undcr.468 F.S, to make such IIJ\ <br />in:;pcction, lnelude photographs of c:ach plane of the mofwith the permit #- or address #- clc:ady shown m8Ikcd on the: <br />deek for each in'J)cct1on, <br /> <br />