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10/16/2009 16:02 FAX (1001/001 <br /> F T O — oo J <br /> City f Zephyr hills <br /> B : e DING DEPAR.TIVIENT <br /> RE: Permit # 9663 9/17/07 <br /> Inspection Affidavit <br /> I / 0✓ ,9 "" ,licensed as a(n) Contractor* /Engineer/Architect, <br /> (plcaae print name and circle Lic. Type) FS 468 Building Inspector* <br /> License #; a ez- /3 <br /> • <br /> On or about Ipee 9 , I did personally inspect the roof <br /> deck nailing and/or secondary water barrier work at <br /> (circle one) (Job Site Address) <br /> 1 /72 / L ffot.Ct.' & . 2ty/ ..oi iS �z <br /> Based upon that examination I have determined the installation was done according to the <br /> I3 "cane Mitigation Retrofit Manual (Based on 553.844 F.S.) <br /> • <br /> • <br /> STATE OF FLORIDA <br /> COUNTY OF // �/ <br /> Sworn to and subscribed before me this /b day of Bodobl . . 200 ? <br /> By gtL t K /f ig <br /> Notary Public, State of Florida <br /> (Print, type or stamp name) <br /> 1 <br /> Personally (mown ,/ or w~ ANNA tweets LYNCH-TERRY <br /> .,- <br /> Produced Identification " Peale . gem of m <br /> Type of identification produced. ' c e`"'0 " �o► , 2012 <br /> Thom <br /> General, Building, Residential, or Ro m <br /> �B� Roofing Contractor or any indivi � -"' . �. _ ... , .., <br /> inspection. Include photographs of each plane of the roof with the permit # or address 0 clearly shown .... . • the <br /> deck for each inspection. <br /> • <br />