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City i,of Zephyrhills <br /> BUILDING DEPARTMENT <br /> RE: Permit # q32-s- 9/17/07 <br /> ;Inspection Affidavit <br /> ( _ /Engineer/Architect, <br /> I C � ‘ ,licensed as a(n ontracto �� <br /> (please print name and circle Lic. Type) ' • 8 Building Inspector* <br /> License #; /C- OV V/ • <br /> On or about 3 VO 9, , I did personally inspect the roof <br /> deck nailin l and /or seconda water barrier . k at J /2 / / S <br /> (Job Site Address) <br /> Based upon that examination I have determined the installation was done according to the <br /> Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.) Signature <br /> STATE OF FLORDA <br /> COUNTY OF Goc° <br /> Sworn to a n d subscribed b e f o r e me this / S day of 11-I v . 200 9 <br /> By kicity L/ <br /> Ns A. • 1 • ic, - of orida <br /> AFOk, JANICE M. HELMS L i <br /> MY COMMISSION # DD 451295 Pe ) <br /> i,.o= EXPIRES: September 10, 2009 l�+ <br /> ,`g� Bonde 7 hru iVctery Public Underwriters (Print, � • e or / u..p name) ciri ; c e IM <br /> Commission No.: �/ Z� <br /> Personally known ✓ 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 /> • <br />