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<br />AUG /1')" I? f1r\ '7 /tff\li "';'.7':: !:If <br />; L....f J;..,J...j/..~..~_<...L...i-.... o.,..t <br /> <br />ZEPHYRHI lJ.S WILD It(; <br /> <br />PAZ No. 813-780-0021 <br /> <br />P. 001/00: <br /> <br />Citym~' <br />BUR JDINGBEPAtlDIENT <br /> <br />RE: Permit # __J<6<6<i? . 9/17107. <br /> <br />JD.~tion'Aftida'dt <br /> <br />I ~\cra m Co. r-D.v1\ ,liCCDlCdasa(n)CoDtnIctor* /EnginccrI~ <br />(plcllsDpri8tDllll8~c:bdDlic. '1)pe) . . . FS 468 BoiJ~ lDs~r* <br /> <br />Liceme#;~ RC- 00'617.tL>'j <br /> <br />On or about <br /> <br />t I did ~ iDspect tho!:R9f <br /> <br />(J:JIa" time) <br />ded:nailinV and/or ~ water bari1er work at ~ 171 ~ he~aJL ffr-.e-. , <br />. (c:bde~ (JobSiteAddnss) <br />. 2.- - ~ r -e . <br /> <br /> <br />- <br />. 'on I havo dc:At;, mifled the inPllsdion was done accontiDg to the <br />Manual (Based on 553.844 F.S.) <br /> <br />S. <br /> <br />STATE OF FLORIDA <br />COUN'IY OF . <br />Sworn to and subscribed be10rc me this. . ~ of <br />. - -- . <br /> <br />.200_ <br /> <br />By. <br /> <br />~otary Public, State ofFJmida <br /> <br />(PriDt, type or stamp name) . <br /> <br />Ccmmission No.: <br /> <br />Personally known ~ or <br />Produced ldemification <br />Type ofidenti:fication produCAfi. <br /> <br />* Gauza1. BuiJdiac.1I,.,n~1~ or ~ ew...... ....y....... ~ 1JDdc:r;468 P.s.. mJll8ke lOch an <br />iaspcctiao.lPc1D1k ~ of.ah p1Bo otthcJOOtwilh tbepmaitft. ~.....fI cIady sbowa aambd CIIl the . <br />deck ibt e8Ch iup:lctioa . . . .. <br /> <br />, <br />