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<br />. . <br /> <br />City of ZeJmyrhiIls <br />BUILDING DEPARTMENT <br /> <br />RE: Permit # 77ql <br /> <br />9/17/07 <br /> <br />Inspection Affidavit <br /> <br /> <br />I &ott-R/~cfMCUj <br /> <br />(pleaslC print name and circle Lie. Type) <br /> <br />License #('C C OS- 7 9-57 <br />On or about '-//25/05" 3 ,100 ,:JfI\. , I did personally inspect the roof <br />tDate & time) <br />ork at G:A /) / (,+1,3+ <br />(Job Site Address) <br /> <br />,licemed as . '~)lEngin_/kchitect, <br />~~lding Inspector* <br /> <br />Based upon that examination I have detenniJed 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 11 ~ ~' I <br />Sworn to and subscribed before me this~day of <br /> <br />By cy(!:)t{- 43JQ c.J:'JIV\CtJ;\ . <br />. Notary Public, State of Florida <br /> <br />CM/.~ ~ <br />(Print, type or stamp name) <br /> <br />.200-2' <br /> <br />Personally knO~ or <br />Produced Identificatlon~ <br />Type of identification produced. <br /> <br />Commission No.: <br /> <br />. Genenll, Building, Residential, or Roofing ContractoJ" or any individual certified under,468 F.S. to makt: sucb 821 <br />inspection. Include pbotogrsphs of each pl_e of the .-oofwith the pc:nnit 1/ or addres!l # clclIdy shown marked on the <br />dcck for each in:JpCCtlon. <br /> <br />. CORf ANN ICEOUGH <br />--,.. ..."..... <br />· . C.Il' r '~AIlg17.2DtO <br />CnI' . ,'DD_ <br />....... .. --.. AIM. <br />