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• <br /> City of Zephyrhills <br /> BUILDING DEPARTMENT <br /> RE: Permit # 9 51 9/17/07 <br /> Inspection Affidavit <br /> I �� " / `� � ,licensed as a(n) Contractor* /Engineer /Architect, <br /> (please p rint ame and circle Lic. Type) FS 468 Building Inspector* <br /> License #; e 'LC, ( 3 9 9 <br /> On or about NG 1 (( D 7 , I did personally inspect the roof <br /> (Date & time <br /> deck nailing and /or secondary water barrier work at 3 U Q 6 -2--( , <br /> (circle one) (Job Site Address) <br /> Based upon that examination I have determined the installation was done according to the <br /> Hurricane Miti ti. • Retro t Manu. II: - . • .: 44 F.S.) <br /> / '/ <br /> • e <br /> '4' <br /> STATE OF FLORIDA <br /> COUNTY OF ' 1 <br /> Sworn to and subscribed before me this 1 © day of Ivan -ll . 200_j <br /> By ' if - ' ; <br /> /Le . <br /> Notary Public, State of Florida <br /> 0:V4 JACQUELINE BOGES <br /> leg Commission 00 621833 <br /> v_ � � t Ares December 12. 2010 <br /> (Print, typ . 's .'Ili. fit"""'"'" <br /> Commission No.: <br /> Personally known 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 />