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01/22/2010 09:55 8137801805 BARTLETT ROOFING PAGE 02 <br /> • <br /> City of ep yrhrlls <br /> BIJJ.DING DFP.RTMENT <br /> RE: Permit # 1 vb 1 9/17/07 <br /> • <br /> Inspection Affidavit <br /> 1 _If Chu t4-1.01' . ,licensed as a(n) Contractor* /Engineer/Architect, <br /> (please print nemo and circle Lc_ Type) FS 468 Building Inspector* <br /> License #; c252-. <br /> On or about l 2Z-'Z d 1 U , I did personally inspect the reof <br /> etc & {nne) <br /> • <br /> deck nailing <br /> and/or secondary water barrier work at Ail <br /> (circle one) (Job Site Address) <br /> 397 a 4a.1 , • . < G 4. . 3• I . <br /> Based upon that examination I have determined the installation was done according to the <br /> Hurricane "ti : o I Retrofit ; ' _ ; _. a n 53.844 F.S. ) <br /> v.' <br /> • <br /> • <br /> STATE OF FLORIDA <br /> • <br /> COUNTY OF <br /> Sworn • . . scribed before me this. day of J . 200Ld <br /> • <br /> By • , s2 1.5// � <br /> "" " / JACQU " INE BOGES Notary Public, State of Florida <br /> :•= Commission DD 621833 <br /> ,17: ejr4s Dacember 12, 2010 1 Ql e t r f �)-e h ( <br /> Nf � 1hN troy nw 4004.. -7410 <br /> (Print, typ4/or stamp m <br /> • <br /> Connmiission No.: Date. 21%6 <br /> Personally known , or <br /> Produced Identification <br /> Type of identification produced. <br /> a 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 perosit # or address # clearly shown marked on the - <br /> deck for each inspection. <br />