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JUNI12/2008/THU 08:52 AM ZEPHYRHILLS BUILDING FA No, 21S-780-0021 P. 00 i/ory <br /> • <br /> . . . . <br /> . . <br /> . . • . <br /> ' . . <br /> . • . <br /> . . <br /> • . <br /> . City of Zepli*thills. . <br /> • • . • <br /> BUEUDING DEPARTMENT <br /> RE:Permit # <br /> • I – I 1 . . <br /> • . . 9/17/07 • . <br /> . • <br /> • <br /> ' . Inspection Affidavit <br /> . . . . . . <br /> • • ,. <br /> • <br /> 1 !....;,,.. 1 li . 5,7_, ''V.A.,pc ,licensed as a(n) .Contractor* /Engineer/Architect, . <br /> (pleaseprint name and circle Lie. Type) - • FS 468•Buncling Inspector* . <br /> ... <br /> License #; C C C 0 - 8 13 L{ • .• <br /> . . <br /> • <br /> On or about • ,c-, - Nq - ?c(7ci. • , I did personally inspect the rciof . . <br /> . — <br /> (1._.deck nailing and/or secondary water barrier Work at . .5 : 1 5 4 LI- 4 C <br /> • (Job Site Address) <br /> . • • <- 7'..OV' r 1 1 \ • ‘ \ . . <br /> Based utha - . is ' 1 ation I have determined the installation was done according to the <br /> Hurrica4e Miti :at. i, Retrofit MAJamal.:(Based on 553.844 F.S.) , • <br /> '11 / • 1 , <br /> . • <br /> idiI : • . . <br /> Si a. .w <br /> . . . <br /> • I; • \ \' . . <br /> - . <br /> • .- <br /> • STATE • F •FLORIDA <br /> • CO OF - . . <br /> • c-.:. <br /> • . Sworn to : .d subscribed' before me this- 1. - 't day of .•.--- c---- ,- ) t_ . 200 9 • <br /> V L • r i i I 'a - <br /> ay AA 1 41, /Z14 • . ' • • <br /> • <br /> • <br /> k <br /> 1 :"•••• I 4. . <br /> . • .• ,,, ;,,IM IVSSI IIIM121911411 014 4 00 805627 . ' . <br /> . • ?; -'-,„''' kt • EXPIRES:July 14, 2012 • . <br /> . • It Cicadae Tbru Holm Pubk tindenwite; . . <br /> • • <br /> . . , . ( nnr, type orstamp flamer <br /> - - <br /> • ' . . <br /> • . <br /> .,./. , '• : . • Commission No.: DI)5301_27.0;177 . <br /> . . <br /> Personally laiown or • • , . <br /> Produced Identification . • . <br /> Type of identification . . produced. . • <br /> . . <br /> . * GCP.ealil, 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 tlie roof with the permit # or address # clearly shown marked on the , <br /> . . • deck for each inspection. . • ' • • <br /> . . <br /> ,. . . . <br /> . . . . . <br /> : • . <br /> • . <br /> • . . • <br /> . • <br /> . • , . . . ' . . . <br /> , • • . . <br /> • • . • <br /> . . . , <br /> . . <br /> . • <br /> . . • . <br /> . • . . . . . <br /> . . . . . <br /> . . <br /> . _ <br /> TOO/TOOZ XV.3 60:T 600Z/ZZ/90 <br />