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i <br /> el3 7130- 001_ <br /> f K <br /> City 1,of Zephyrhills <br /> BUILDING DEPARTMENT <br /> 9/17/07 <br /> RE: Permit # 10 <br /> Ins pection �fidavit <br /> I ; n A - o N w A cc -i— ,licensed as a(n) Contractor* /Engineer /Architect, <br /> (please print nanii and circle Lic. Type) <br /> FS 468 Building Inspector* <br /> License #; CC ('J o 1-1 7 (oa <br /> On or about 5 <br /> , I did personally inspect the roof <br /> (Date & time) <br /> deck nailing and /or secondary water barrier work at _ 5 - 7 Yore-AA, j7r ' <br /> (circle one) (Job Site Address) <br /> Based upon that examination I have determined the installation was done according to the <br /> mac. ; - 'ligation Retrofit Manual (Based on 553.844 F.S.) <br /> 1 /10111*- <br /> *nature <br /> STATE OF FLORIDA <br /> COUNTY OF <br /> Sworn to and subscribed before me this day of /4 1 . <br /> By U�.(� /l�n� <br /> Notary Public, State of Florida <br /> Non om n $emon f Florida tJog.1 J1 ttabx - -_ i <br /> a 00130888520 bt4I , <br /> 1� Ex pir C es 0 3ommission /1 112 (Print, <br /> type e or stamp nalne) <br /> Ex <br /> Commission No.: l�'i> Rto 8 5 <br /> Personally known <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 />