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<br />.JURISDICTION OF YOUR CHOICE <br />BUILDING DEPARTMENT <br /> <br />RE: Pennit # ~ <br /> <br />9/17/07 <br /> <br />InSDectiob Affidavit <br /> <br />I j( atLJ31 ~~M"'- II'. <br /> <br />(please print name and circle Lic. Type) <br /> <br />License#; C C C. Or 7 ~ S-7 <br /> <br />On or about 7/ d" (0 Y , I did personally inspect the roof' <br />DfIte & time) <br /> <br />~k nailing and/or secondary W(/Ier bQl"riev.ork at (, ~3 5" /Ii Q.. H.. UJu.. 1Jr:. <br />(evele one) (Job Site Addl"C:lS) <br />2f'pk 1~~' 'II ~; F I ___.____.' <br /> <br />Based Upon that examination I have determined the installation was done according to the <br />Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.) <br /> <br />~~/ <br /> <br />Signature <br /> <br />,licensed as a(n~ontrac~ IEngineer/Architecl. <br />FS 468 Building Inspector* <br /> <br />STATE OF FLORIDA <br />COUNTY OF ~ <br />Sworn to and subscribed before me this a day of <br />By S1c oft Ujla..L)uI>1.a;;: <br /> <br />~bl~ri~ <br /> <br />(Print, type or stamp name) <br /> <br />July <br /> <br />-/ <br /> <br />. 200t? <br /> <br />Personally known ~ <br />Produced Identification <br />TyPe of identification Procfuccd. <br /> <br />Commission No.: <br /> <br />~ Gene!'8I, Building, ResidentiaJ. or Roofing Conlr8Ctor Or any individual ccnified under 46& F.S. to rnakc such llII <br />Ill$peCUon. Include photographs of eaeh plane oCtile roof with the permit 1# or ad~ ~ clearly shown marked On the <br />declc for each inspection. <br /> <br /> <br />....... ......~ <br />CUk. AI';/o. ,.f ,)lJGH <br />NoIIfy PuOl/c - Slale Of FIaItIII <br />Commiss.on Ellpite$ Aug 17. _ <br />Commtssioll . 00 586503 <br />BO"rl~ !'l", "i~'I""a' l\IotBty~-. <br />\ '. ....'.... ...,... <br />