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City of .Zeplyrhills <br /> BUILDING DEPARTMENT <br /> RE: Permit # i () `'" 9/17/07 <br /> Ins a ection Affidavit <br /> ' IP 1 <br /> I A i� 1.0 <br /> � � a�.+i� ,licensed as a(n) Contractor* /Engineer /Architect, <br /> (' lease print n • 1. e ar Lic. ype) FS 468 Building Inspector* <br /> License #; 0 C 1 32-5' ci' 619 <br /> On or about 3f _(Q _ ( , I did personally inspect the roof <br /> f <br /> (Date & time) W deck nailing and /or secondary water barrie work a �-- <br /> (circle one) (Job Site Addr <br /> • <br /> Based up en ' = t u 1 at I have determined the installation was done according to the <br /> Hurri i if / en Retrofit Manual (Based on 553.844 F.S.) <br /> - :r %! <br /> Si_ra rv- -i <br /> STATE OF FLORIDA <br /> COUNTY OF <br /> Swo and subscribed before me this 1 7 da y of .208/0 <br /> By e A <br /> Notary Public, State of Florida <br /> ,,, , • JACQUELINE BOGES <br /> (Print, a - A ai'r s �� p er 12 2010 <br /> `' . Bonded Bev troy win Insurance 800. 385-7019 <br /> Commission No.: <br /> Personally known x or <br /> Produced Identific lion <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 /> • <br />