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• <br /> V \ �. j <br /> , � <br /> — -- <br /> V <br /> "SDICTION- =OF Y(U . CHOICE <br /> . BflI;DINGDEPART'ENT • • <br /> . <br /> RE: Permit# . 1 . ' <br /> In sr � ection Affii . . <br /> �% • <br /> • I cL'`, �.C: 1 CA--.:. ,licensed as a(n) Contractor* der /Architect; <br /> { FS 468 Bnilriing Inspector <br /> (please print name and circle Lic Type) - <br /> License #;______1, 1 -- . <br /> ; , �; C � , I did personally inspectthe roo <br /> On or a b o u t • `c ti <br /> (Date & time) / <br /> deck nailin' a nd/or seco n d ary water barrie Fork at (Job Site Address)' <br /> (circle one) r - - - <br /> t on was done according to the <br /> • Based upon , .t 4 . . o l i o • tion I have detenaiine��53.8 •) <br /> - Hurricane T tig Z : on?'• gtrofit Manual (Based <br /> Signature ' ' - <br /> STATE OF FLORIDA . <br /> COUNTY OF 2 00 ='i <br /> Sworn to and subscribed before me this r- day. of 1•_7' `' <br /> . . Nabary Public, State of Florida <br /> {�i <br /> .. ..,....:7.; ,, C ��. �qc . c ta oI . , _ _ _ <br /> `l Flond2 �, <br /> . :1 a \:'. , ..orn r1issic G• f i . <br /> ��7 X319 r - <br /> r CO1S onl3a.: <br /> Personally known • or ! <br /> Produced Identification <br /> Type of identification produced. • <br /> * General. Building, Residential, or Roofing Contractor hr any individual certified =dcr 468 F.S. to make such so <br /> inspection Include photographs of each place oldie roof with the permit # or address # dearly shown marked on the <br /> deck for each inspection. <br /> T00 /T00 21 Xd.3 ZZ :TT 600Z /£0 /IT <br />