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=City aof .Zepbyrhills <br /> BUILDING DEPARTMENT <br /> RE: Permit # Q9_3/ 9/17/07 <br /> Inspection Affidavit <br /> 1 / /) /77/1 A) ,licensed as n a Contractor* <br /> () /Engineer /Architect, <br /> (please print name and Circletic. Type) FS 468 Building Inspector* <br /> License #; ('('d /31 s so c <br /> On or about /l ej (,p , I did personally inspect the roof <br /> a te e) <br /> deck nailing and /or secondary water barrier work at <br /> (circle one) (Job Site Address) <br /> 636 7 / /riLe,>t 94, s. ,0 /1, 2- /a //s / . <br /> Based upon that examination I have determined the installation was done according to the <br /> Hurricane ti � rricane Mi ation Retrofit Manual (Based on 553.844 F.S.) <br /> 01 <br /> 411kture <br /> STATE OF FLORIDA <br /> COUNTY OF <br /> Sworn to and subscribed before me this t_ day of ‘c.,(2„,., („ f-- _. 200a <br /> By kev `[ ov.N <br /> otary Public, State of Florida <br /> 40 , s Npta R li State of Florida <br /> hnstian Rym J \, J `�- , <br /> 4 <br /> "r MY t Arnfnision DD751S10 <br /> 1 <br /> or n Expirem G1 24/2012 (Prin , type or stamp name) <br /> ‘V or <br /> 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 /> • <br /> • <br />