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10-10002
Zephyrhills
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10-10002
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Last modified
1/26/2011 8:14:46 AM
Creation date
1/26/2011 8:14:44 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
10-10002
Building Department - Name
KEENE,DONALD R
Address
6844 NORTHLAKE DR
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01/21/2010 07:50 FAX Z002/002 <br /> City <br /> .Zephyrhills <br /> • I G DEPARTMENT <br /> RE: Permit # / ow 2 9/17/07 <br /> • <br /> inspection Affidavit <br /> I <br /> ii.dui 4 ,licensed <br /> as a(n) Contractor* /Engineer/Architect, <br /> (please print name and circle Lk. Type) FS 468 Building Inspector* <br /> License #; ea C /3,Z roc- • <br /> On or about j— / 9-/o I did personally inspect the roc <br /> (Date & tune) <br /> deck nailinr a • or secondary water barrier work at <br /> (circle one) n (Job Site Address) <br /> r. <br /> 9 5t /v0-7-� ECG .04 . - 2.€,AyJ,/ii !Z • <br /> Based upon that examination I have determined the installation was done according to the <br /> H - cane - tigation Retrofit Manual (Based on 553.844 F.S.) <br /> tare <br /> STATE OF FLORIDA <br /> COUNTY OF <br /> Swom and subscribed before me this. 2/ay of <br /> 2/day . 20'10 <br /> By • <br /> Notary ; Pub�lic, State of Florida <br /> (Print, type or stamp name) <br /> Personally known or Commission No.: <br /> Produced Identification ; ""r'7,�••,� ANNA MARIE LYNCN•TERRY <br /> +Q `• Notary Pubne - alma or Florida <br /> Type of identification produced -� My coin <br /> aresion Eapiros Apr 1 . 201 2 <br /> r 'zt_. ' Commission U DO 740169 <br /> Building, Residential, or Roofing Contractor ? OirWrshlinicilikliP4101Plasto . such an <br /> inspection. Include photographs of each plane of the roof with the perini_ a# or itZdahrfflt marked on the . <br /> deck for each inspection. <br />
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