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<br />:City of ZeWrhills <br />BUILDING DEPARTMENT <br /> <br />RE: Pemrit # 21,g <br /> <br />9/17/07 <br /> <br />Inspection Affidavit <br /> <br />I k,v~" ~~ <br />(plc:asc print name cmd citcle Lie. Type) <br /> <br />,liccmed as a(n) Contractor* /Engineer/Architect, <br />FS468Builmng~ecto~ <br /> <br />License #; c...c...c.... \ ~ S5"'O':> <br /> <br />On or about 8/14/02 JO:dD~ <br />(Date & time) <br /> <br />@ na~dlQr secondarv water barrier work at <br />(dl'cle. OIl4!) <br />~\.d~,'~, R... 3~~~ <br /> <br />I I did pS'9onally inspect the ,.oof <br /> <br />Sql{O Cf +~ S-+ , <br />(Job Site Address) <br /> <br />Based upon that examination I have determined the installation was done according to the <br />~~lit Manusl (Based on 553.844 F.B.) <br /> <br />STATE OF FLORIDA <br />COUNTY OF <br />~~metbis~daYof ~~ <br /> <br /> <br />~~~." -',. .>- _ Notary Public, State of Florida <br /> <br />~ .......J .._ <br />f~"" ti; ~PullllCs..'ofF\allG. <br />.:: -: - GYdU.... Ryman <br />~ ..:;. ~ p'.. . IJYcommllllOll OD751e10 <br />;: - __ ~'O"2612Q12 <br />'%~"""' ... ".." /" <br /> <br />~':"':~~onallY'laiown V or <br />Produced Ideo.tincation_ <br />Type of identification produced. <br /> <br />.200~ <br /> <br /> <br />c~~ ~~ <br />(print, type or statnp 'name) . <br /> <br />Commission No.: <br /> <br />· Gmunl, Building, RClIidealia1, or RoofiDs ConlDctar or my individual certified under 468 P.S, to mBke such BD <br />inspection.. Include photognspbs of aid! plane of the roofwith the permit # or address # clearly shown mar1c:ed on the <br />deck for each iDlpection. ' <br /> <br />lOO/lOO~ <br /> <br />xv~ ~O:~l 800G/~L/80 <br />