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07/21/2009 08:28 FAX ZI002/002 <br /> Ci Hof 2 eu <br /> 'BUILDING DEPARTMENT <br /> 9/17/07 <br /> RE: Permit #s`� — - <br /> Ins �ection affidavit <br /> I <br /> PcL(,L( �1� f ,licensed as a(n) Contractor* /Engineer /Architect, <br /> � <br /> lease ht name and l e � Lie. Type) <br /> FS 468 Building Inspector* <br /> (P pr <br /> in <br /> #; .e ) 05 3I 3`f <br /> • <br /> On or about ' (9-O Oci , I did personally inspect the roof <br /> (Date Sr. time) <br /> __ .. c�s4" e)3 `),Irp <br /> deck nailing and /or secondary water barrier „Work a (Job Site Address) <br /> ( circle one ._, - -•�'� <br /> Based po . at examination I have determined the 5 8 F io was done according to the <br /> Hurri. i. e ,� ' •gation Retrofit Manual (Based on <br /> STATE OF FLORIDA <br /> COUNTY OF <br /> Sworn to and subscribed before me thin o day of <br /> Y 0.1/1/0- 3.4/Kigja • <br /> EXPIRES: July 14, 2012 <br /> Bonded Tlw Notary Public UndsVnders <br /> (Print, type or stamp name) <br /> Commission No.: bbRacO%1 <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 />