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C s.. of Ze t ..rli-ills <br /> BUILDING DEPARTMENT <br /> goq( 9/17/07 <br /> RE: Permit # <br /> Inspection Mfidavit <br /> 1 , I A� /Engineer/Architect, <br /> ,_,, i/u / f - Allicensed as a(n) C ontractor* /Engin <br /> 1 � � � '� FS 468 Building Inspector <br /> .lease prin - an ctrc e c. Type) <br /> icense #; C_A� _1 ?J 15- S4 119 <br /> On or about , I did personally inspect the roof <br /> (D. : time) Q i ' / _ <br /> 1 <br /> deck nailing and /o seconda water barrier work at (Job Site Ad•• <br /> (circle one) / <br /> � i ` <br /> „ r4 ....,r on 1 h a ve determined the installation as do , e according to the <br /> gam. l I A 're .. on Retrofit Manual (Based <br /> STATE OF FLORIDA <br /> COUNTY OF , n 200 <br /> Sworn to and subscribed before me this - 5 day of I �/l <br /> By Notary Public, State of Florida <br /> ,.Qtip:: ; , JACQUELINE BOGES <br /> • ' , , � .: Commission e DD A21R.'3 <br /> - <br /> (Print, ••- -: t� ` m r r 12, 201 <br /> 'f.t ,-' ?Y 1M nc1 0 10 0 <br /> Commission No.: <br /> Personally known IC 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 />