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City of Zephyrhills <br /> 4 BUILDING DEPARTMENT <br /> RE: Permit # t� / 9i17/07 <br /> Inspection Affidavit <br /> I G497Y ,& (ku e; . -, ,licensed as a(.! Contracto /Engineer /Architect, <br /> (please print name and circle Lic. Type) • . : Building Inspector* <br /> License #; C ( , L , '7 S <br /> On or about I / j , I did personally inspect the roof <br /> (Date & • <br /> deck nailing and /or secondary water barrier wor at 3 ` 3 9' - f <br /> — — (Job Site Address) <br /> .rdr P/ <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 /> ignature <br /> STATE OF FLORIDA <br /> COUNTY OF <br /> Sworn to and subscribed before me this day of . 200 <br /> By <br /> Notary Public, State of Florida <br /> (Print, type or stamp name) <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 />