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<br />iCity ~of _Zepbyr:hills <br />BUII.1DING DEPAR!fMENI' <br />RE: Permit# !tJ3"7' <br /> <br /> <br />9/17/07 <br /> <br />Inspection Affidavit <br /> <br />'\ 1/ OJ\J ~ f\j ':-1 ^ lVJ,rJJ .. . <br />I .;J. It) v . I \ t VI J I ,hcensed as a(n) Contractor* /Engmeer/ Architect, <br />(please print name and circle Lie. Type) r' " FS 468 Bwlding Inspector* <br />-. "O-r-Ql <br />License #; (L. L. ) t? J-.J <br /> <br />On or about 7., 7.,.Ob; 1/: 3 u A^'1 <br />(Date & time) <br /> <br />, I did personally inspect the roof <br /> <br />deck nailin nd/or seconda water barrier work at 37J'I t i'lf/lEJE#1 f)~. <br />(circle one) (Job Site Address) <br />~_ ZEftI'f(LI.fI1-L~i ~Lr 33ry ( <br /> <br /> <br />at examination I have determined the installation was done according to the <br />i . ation Retrofit Manual (Based on 553.844 F.S.) <br /> <br />.' I/iff-~{'fv' - ~--- . <br /> <br />STATE OF FLORIDA <br />COUNTY OF . <br />Sworn to and subscribed before me tbi~ day of ~ 4 .200 B <br /> <br />BY~<?f',Oi'\ (\QA)~ . <br />Notary Public, State of Florida <br /> <br />_~r\iu;L l~-er <br /> <br />(print, type or stamp name) <br /> <br />Commission No.: 1) D l cr 14 ~ <br />MARTHA C. LEGER <br />NOTARY PUBLIC. STATE OF FLORIDA <br />coMMISSION # 00791489 <br />EXPIRES 811812012 <br />Al'WnFnTMRU l-88I-NOTARY1 <br /> <br />Personally known ) or <br />ro uced Identification <br />Type of identification produced. <br /> <br />* General, Building, Residential, or Roofing Contractor or any individual certified under 468 F.S. to make such an <br />inspection. Include photographs of each plane of the roof with the permit # or address # clearly shown marked on the <br />deck for each inspection. <br />