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City • of Zepliyr'hills <br /> BUILDING DEPARTMENT <br /> RE: Permit # 9S75 9/17/07 <br /> Inspection Affidavit <br /> I /A) lam` I9'4) ,licensed as a(n) Contractor* /Engineer /Architect, <br /> (please print name and circle L(c. Type) FS 468 Building Inspector* <br /> License #; e C e- /3 2,5--s--o 5 <br /> On or about Y/Z7/4 , I did personally inspect the roof <br /> ate me <br /> deck nailing and /or secondary water barrier work at , <br /> (circle one) y ob Site Address) <br /> 3 x6 , 07 4 Li // , 4 33 <br /> Based upon that examination I have determined the installation was done according to the <br /> Hurrico, itigation : -trofit Manual (Based on 553.844 F.S.) <br /> �I <br /> Si <br /> E OF FLORIDA <br /> OUNTY OF <br /> Sworn to and subscribed before me this zf day of 47t,e,c . 200/ <br /> By . <br /> Notary Public, State of Florida c---- <br /> (Print, type or stamp name) / <br /> ...!.... ANNA MARIE LYNCH -TERRY <br /> / CO .MOlMY Public - State of FIn, 4 <br /> Personally known ( or .41'.'21i4 •21 elon Ems« Apr 4, 2012 <br /> 4 Commission • DD 740168 <br /> Produced Identification : d . loaded Through Wong Nary Assn <br /> Type of identification produced. — — — <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 permit # or address # clearly shown marked on the . <br /> deck for each inspection. <br />