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<br />'<City ~of .Zepbynhills <br />;BUII..iDING DEP ARtrMEN'if <br /> <br />RE: Permit # <br /> <br />9/17/07 <br /> <br />Inspection Affidavit <br /> <br />I~~~ <br /> <br />(please print name and circle Lic. Type) <br /> <br />,licensed as a(n) Contractor* /Engineer/Architect, <br />FS 468 BuIlding Inspector* <br /> <br />License #; <br /> <br />On or about <br /> <br />r - )--fJ cP <br /> <br />(Date & time) <br /> <br />, I did personally inspect the roof <br />)1- :J) -( cP ~ f--:--- <br /> <br />, <br /> <br />(Job Site Address) <br /> <br />deck nailinf! and/or secondary water barrier work at <br />(circle one) <br /> <br /> <br />aye determined the installation was done according to the <br />t Manual (Based on 553.844 F.S.) <br /> <br />STATE OF FLORIDA <br />COUNTY OF <br />Sworn to and subscribed before me this ,_day of <br /> <br />.200 <br /> <br />By <br /> <br />Notary Public, State of Florida <br /> <br />(Print, type or stamp name) <br /> <br />Commission No.: <br /> <br />Personally known or <br />Produced 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 pennit # or address # clearly shown marked on the <br />deck for each inspection. <br />