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<br />08/19/2008 12:21 FAX <br /> <br />~001l001 <br /> <br />\Ciity (Of .Zepb:yrhills <br />BUILDING DEll ARlfMENif <br /> <br />RE: Permit# -; .y(.;~ 1"1 <br /> <br />9/17/07 <br /> <br />,'" ~-.. ., <br /> <br />Inspection kffidavit <br /> <br />~."..\ <br />I :,jC'~L' t ,:~) C.t'le." ")('.'\<:.> <br />(please print name and circle Lie. Type) <br /> <br />,licensed as a(n) Contractor* /Engineer/Architect, <br />FS 468 Building Inspector* <br /> <br />License #; (: C .' C (')')::;' l;; '-{. <br /> <br />On or about ..~; i Lr! C' \}. <br />(Date & time) <br /> <br />, I did personally inspect the roof <br /> <br />~_"....__..'--::::-::.,.._..,~,.,...._ n_.......... " "- <br />(aeck n:ailingand(6r secondary water barri~~ work at <br /> <br />.. . -._.......__.. .. (crtcls-.one)..........................-...-.............. <br /> <br />.."," <br />,.---..--.......... <br /> <br />.; h.., <br />i.-T<-)" i 7 ''6 <br />(Job Site Address) <br /> <br />.<:~:) "rif (.~; ~:.-1.' <br /> <br />",,-- 2:: (:' ,.:!\., \ 'f " t., , ' ;' /.~:' <br />. J <br /> <br />/"-''''' L"...-:J......... <br /> <br /> <br />ation I have determined the installation was done according to the <br />etrofit Manual (Based on 553.844 F.S.) <br /> <br />Signature <br /> <br />STATE OF FLORIDA <br />COUNTY OF <br />Sworn to and subscribed before D;1e this.! c; day of <br />". (. ( ! ,I I n <br />By I" '.! Jr,.. ~: '.., . / ....<, ;\-.\....\"'1" If /1 /\ /,\j <br />./ . .'\:\ ~...,...( :,' ,~!:-''' ! ,.' \ _; 1 \. /./ \ l..It.. .j ..,V <br />I U No <br /> <br />!", <br />Hli (ll'.sf. <br />i '~;I ".' <br /> <br />.200-2 <br /> <br />Personally known .,/ or <br />Produced ldentification_ <br />Type of identification produced. <br /> <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 Toof with the permit # or address # clearly shown marked on the <br />deck for each inspection. <br /> <br />~.:....::-.''''_.'''-'.:::==:~=..''="=.::,="'=~,~:,,''"~-=..;==._m...._._._.~.-......__.... ..__..................._"._........._._........._.....,......._......._.._ ___o_.u.__ <br /> <br />.~..._-._._.,.._.'.._-,._....._._.-.....-._.._-._......_._----.....................-....-....--....................-.........- <br />....---- <br />