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City iof Zephrrhills <br /> DING DEPARTMENT <br /> RE: Permit # 0// 9/17/07 <br /> Inspection Affidavit <br /> I / Cif A////v ,licensed as a(n) oC ntracto /Engineer /Architect, <br /> (please print name and circle Lic. Type) ' e 8 Building Inspector* <br /> License #; ;X- 00 Vet. <br /> On or about 0, ®9- , I did personally inspect the roof <br /> ate & time) <br /> deck nailing and /or secondary water barrier w at 3 Z g 5 7; <br /> (circle one) (Job Site Address) <br /> -?-6 • <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 <br /> Swom to and subscribed before me this 2 of 4p-it .200 9 <br /> By kick O.-Qv/4 <br /> Notary Public, State of Florida <br /> (Print, type or stamp name) <br /> Commission No.: M , CAROLYN DRISIELL <br /> MY C � � ` '4- s" # DD 728829 <br /> rs <br /> Personally known ✓ or EXPIRES: November 20, 2011 <br /> Bonded fire Norery Public Underwrite <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 />