Laserfiche WebLink
06/06/2009 08:57 3525674454 MILBAR PAGE 02/02 <br /> ?City iof Zephyrh "ills <br /> B 1 DING DEPAR Q NT <br /> RE: Permit # 9 is; \ 9/17/07 <br /> Inspection Affidavit <br /> • <br /> I �2�� d l�► ,licensed as a(n) Contractor* /Engineer /Architect, <br /> (please print name and circle Lic. Type) FS 468 Building Inspector* <br /> License #; C.C.0 ost51.2 <br /> On or about O( ohti,Dy , I did personally inspect the roof <br /> --� - r (JAM & time) <br /> ec_k na r are r secondary water ba work at o 2. .t <br /> (circle one) (Job Site Address) <br /> Based upon that examination I have detennined the installation was done according to the <br /> Hurricane • "gation Retrofit Manual (Based. on 553.844 F.S.) <br /> Id" <br /> Signature <br /> STATE OF FLORIDA <br /> COUNTY OF <br /> Sworn to and subscribed before me this. 5 day of . 2009 <br /> By • <br /> Notary Public, State of Florida <br /> OUVIA A. <br /> a 'r COAMNit1oN IO 4e <br /> (Prin �� , atom <br /> • carrwV <br /> Commission No,: <br /> Personally known L.. or <br /> Produced Identification <br /> Type of identification produced. <br /> s' General, Building, Residential; or Roofing Contactor or any individual certified under 468 F.S, to make such an <br /> inspection. Include photographs of each plane ofthe roof with the permit # or address # clearly shown marked on the . <br /> deck for each inspection. <br />