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Oct 29 09 11:11a Rick Gavin 352 - 567 -5034 p.2 <br /> (3- 75o - <br /> City Hof .Zephyrhills <br /> BUILDING DEPARTMENT <br /> RE: Permit # 96 9/17/07 <br /> Inspection Affidavit <br /> I /?ic 6/W/i✓ - ,licensed as a(n) Contractor* /Engineer /Architect, <br /> (please print name and circle Lic. Type) FS 468 Building Inspector* <br /> License #; <br /> On or about /O/ y , I did personally inspect the roof <br /> BFtimi - <br /> ec naz iris and /or secondary water barrier work . ` 9S7 /L /f DG'[��'D� � I' .2-4 <br /> (circ e one (Job Site Address) <br /> Based upon that examination I have determined the installation was done according to the <br /> Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.) <br /> Signature <br /> STATE OF FLORIDA <br /> COUNTY OF /1.1 <br /> Sworn to and subscribed before me this 2 'day of (4C' 4(4- . 200 '! <br /> By e c k- t y L. <br /> Notary P . i , State ► " lorida <br /> et JANICE M. HELMS . �C /� <br /> MY COMMISSION # DD X207 <br /> pt s BoateddTlvu:t September <br /> Pubi 0 1' t, typ " ante) <br /> Commis ' n No.: <br /> 3) .D cited() 6 fj <br /> Personally known L- or <br /> Produced Identification <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 />