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�,IAR /23 /2000 /SJN '0: :51 PM ZEPHYAHILLS BUILDING PAX No, 813 - 780 - 0021 P. 001 /001 <br /> • <br /> • <br /> • <br /> . " F iof:Ze 0 IL hills' <br /> • ; ;, i 5 LING DEPARTIVIENT <br /> � i ' . . . 9/17,07. • <br /> . . Inspection Affidavit • <br /> =Me /,� as •. ,licensed a(n) :Contractor* /Eugmeer /Architect, <br /> I <br /> JA J / » FS 468 Building Inspector*. <br /> (please print me and circle Lic: Type) .. <br /> License #�, L� �4° 31. 5-5-0 <br /> " 5 U S� � . <br /> On or about <br /> LP . 2u- o 4 • • , .S didp in spect the roa • . <br /> &t ime) ,, <br /> deck nailing , or sec water ba work at o 7 �I /J ,, �' D <br /> , , (circle one) ' (Job Site ) . <br /> • , . Ai4A/7 /5 . h •• 3 • <br /> . , Based upon that .examination 1 have determined the installation was done according to the <br /> ' cane ■ gation Retrofit Manual (Based on 553.844 F.S) - <br /> . <br /> • <br /> • <br /> . STATE OF FLORIDA . .. . <br /> • <br /> • COUNTY OF ' : . •• • .200 <br /> Sworn to and subscribed before nie this• • G� " day of / • - _ • • • • • <br /> p1 • Style M <br /> ki ,, k� ': Commlakin Exalree A0c4.2012 . <br /> Co lion No.: <br /> Person known ":,or' <br /> Producced Identification •. • • ' . • 'Type of identification produced: • . .. , • • <br /> • <br /> * Gmcsal,• Building, Residential; or Roofing CoMolitor: or any individual oerti£ied varier 468 F.S. to Make such as ' <br /> . - : inspection. Include photographs of each Plane of the roof with the pcomit # or.addras #E clearly shown marked on the . <br /> deck •°- each �pecdOII ' <br />