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City , Zephyrhills <br /> B. I DING DEPARTMENT <br /> RE: Permit # -(l (f-1 9/17/07 <br /> Inspection Affidavit <br /> 1 6 Ar- L - r . :l ,licensed as a(n) Contractor* /Engineer /Architect, <br /> (please print name and circle Lic. Type) V FS 468 Building Inspector* <br /> License #; - <br /> • .: about , I did personally insp - • e roof <br /> .- • e & time) <br /> eck nailing and /or secondary water barrier work at <br /> (circle one) (Job Site Address) <br /> Based upon h • - - -- . • - :.. .. - . - •••• ' -, - , _: _ '.:.: -_. : -. :. • ... ::. - . . . 'n • . •• e <br /> Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.) <br /> ignature <br /> STATE OF FLORIDA <br /> COUNTY OF <br /> worn to and subscribed before me this 2- day of / Cul . 200 3 <br /> By No P+ : ►:-�,to; F • : • - .l <br /> r II <br /> � / ,i {t .. p name) / <br /> . 1 4 , : i <br /> v: ; JACQUELINE BOGES <br /> , <br /> Commission *fa. :*: Commission DT1 R918.13 <br /> Personally known or -'A** Expires December 12, 2010 <br /> R r , �h4P'' aP a.a Thne Tray FPM in.Pnlnc. e40.386-ioi e <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 />