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City of _ Zephyrhills <br /> B. 0 DING DEPARTMENT <br /> RE: Permit # /6/( 5 9/17/07 <br /> Inspection Affidavit <br /> �� • / , icense . as a(n) Contractor * /Engineer /Architect, <br /> (please print name .1 d • le Lic. Type) FS 468 Building Inspector* <br /> License #; <br /> •.:.r about , I did personally inspec n : . <br /> (Date & time) ., <br /> eck nailing and/or secondary water barrier work at 3z((...1 <br /> (circle one) (Job Site Address) <br /> Based upon that eJ•• ' i atio I have determined the installation was de • - . • -:. _ • •• e <br /> Humc.r, • r ..i . , _...... - • -. on . F.S.) <br /> rri�fP, <br /> Si <br /> STATE OF FLORIDA <br /> COUNTY OF <br /> Sworn to and subscribed before me this 2 k day of Pe r a-Y y . 200 /0 <br /> By <br /> Notary Public, State of Florida <br /> 40k''v ti JACQUELINE BOGES <br /> A Commission DD 621833 <br /> .,�.: �. = r• ��.. 0 <br /> (Print, 1Z,ZU1 <br /> ': .,, y �: �e..i�ir1( =� 106r16 <br /> Commission No.: <br /> Personally known )0 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 />