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<br />City of ZeJiliyrhills <br />Bun.DING DEPARTMENT <br /> <br />RE: Permit # 7rO' <br /> <br />9/17/07 <br /> <br />Inspection Affidavit <br /> <br />I ~(ott Bl~~ <br /> <br />(please print name and circle Ljc, Type) <br /> <br />,licensed as ~ /Engineer/Architect, <br />~~uilding lnspector* <br /> <br />.License #;C.~L o!, 19 ~-, <br /> <br />On or about Lf) l..~ J 0 V , I did personally inspect the roof <br />, r(Date & time) <br /> <br />(deck nailing and/or secondarv water b~ work at bGJ 1 c) l.'\, n. f-'- vet <br />- (cirte.lf! .....~I - (Job Site Ad~) <br /> <br />_ '2 <- p'" 7 y ~ .' L I .s I F I h'" I bl ~ _ <br /> <br />Ba.~ed upon that examination I have determined the installation wao;; 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 />COUNlYOF '" ~ 'I <br />Sworn to and subscribed before me this 2q day of r I <br /> <br />By &Ott- (K ttl LlMQV' <br />Notary Public, State of Florida <br /> <br />~.~~ <br /> <br />(Print, type or stamp name) <br /> <br />,200? <br /> <br />Personally known -A. or <br />Produced Identification____ <br />Type of identification produced. <br /> <br />Commission No.: <br /> <br />.. General, Building, Residential, or Roofing Contractor or my individual certified under 468 F .5. to make such an <br />inspection. Include phorograpb, of each plane of the roof with the pc:nnit # or address # clcarly shown marked on the <br />deck for etIlch inJpeCtion. <br /> <br />. .cau._..... <br />.~NII"''''''''''' <br />. . C_.' .......1f. <br />e .. .__ <br />.... __ Ala <br />