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Cty Hof _Zephyrhills <br /> BUILDING DEPARTMENT <br /> RE: Permit # ` / y/7 7 9/17/07 <br /> Inspection Affidavit <br /> I 5t o f f ,(,,744 4* ,licensed as a(n) /Engineer /Architect, <br /> (please print name and circle Lic. Type) FS 468 Building Inspector* <br /> License #; CC LU ? S �1 <br /> On or about ' J Z ! Sr v �"l , I did personally inspect the roof <br /> ate & time) <br /> deck nailin , and /or seconda water barrier work at 6, 3 5 3 ,� 1 hit( 04- 5 7 r <br /> (circle one (Job Site Address) <br /> Z�P kCr 4., 76 ( i <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.) <br /> - Cw <br /> Signature <br /> STATE OF FLORIDA <br /> COUNTY OF <br /> Sworn to and subscribed before me this day of . 200 <br /> By <br /> Notary Public, State of Florida <br /> (Print, type or stamp name) <br /> Commission No.: <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 />