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City iof Zephyrhills <br /> B. : o DING DEPARTMENT <br /> RE: Permit # 3/ 7 9/17/07 <br /> ' :Inspection Affidavit <br /> . 101A6 ; ..• 1 � <br /> ,licensed as a(n) Contractor* /Engineer/Architect, <br /> ,,.lease print n: u e an r 1e Lic. Type FS 468 Building Inspector* <br /> License , L1111� <br /> On or about 7 , I did personally inspect the roof <br /> (Date -' time) <br /> deck nailing and /o secondary water barrier work at <br /> (circle one) (Job Site Address) <br /> Based upon that ex•, +Ig'atio. I have determined the installation was done according to the <br /> Hurric i ' 4: .+ . 0 ::.. + • I .r� ' . .) <br /> rAPr <br /> ..1AL LM <br /> STATE OF FLORIDA <br /> COUNTY OF <br /> Sworn to and subscribed bef oe me this day of 31t(1/ li( f . 2001 <br /> By � i1._ <br /> Notary Public, State of Florida <br /> . 0Y.P .... JACQUELINE BOLES <br /> . ,i I 621033 <br /> (Print, ty � + 214 ber 12, 2010 <br /> 0 1 0,740 ThN Troy FMn Insurance &10386'7 <br /> Commission No.: <br /> Personally known ?C or <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 />