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City of Zephyrhills <br /> BUILDING DEPARTMENT <br /> RE: Permit # 9'2.20 9/17/07 <br /> Inspection Affidavit <br /> I _ . eve A Q 1 5 ,licensed as a(n) Contractor* /Engineer /Architect, <br /> (please print name and circle Lic. Type) FS 468 Building Inspector* <br /> License #; .e, ,d 06 7 7‘ g <br /> On or about a 7 _ O 9 , I did personally inspect the roof <br /> (Date & time) / / <br /> deck nailin • i nd /or secondary water barrier work at 9 f � 4J •tc I <br /> (circle one) (Job Site Address) <br /> �� fI / <br /> p • <br /> Base upon at examination I have determined the installation was done according to the <br /> Hurricane ! 'tigation Retro I anual (Based on 553.844 F.S.) <br /> _; 44 Atli& ... . .. �:ieli/ ■ <br /> Signature / <br /> STATE OF FLORIDA <br /> COUNTY OF ?A S J k <br /> Sworn to and subscribed before me this I S day of Tv' ^ Z- . 200 61 <br /> By <br /> Notary Public, S to of Florida <br /> I di , <br /> DIANE L ateof l D, \C � ( r Y`- <br /> p . Notary Public, State of Florida <br /> ;,.� Commission# DD723350 (Print, type or stamp name) <br /> My comm. expires Oct. 9, 2011 <br /> Commission No.: 7> b 7,)-- 3 S 0 <br /> Personally known or <br /> Produced Identification ✓ <br /> Type of identification produced. r-L- 1 T . <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 />