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07/19/2010 06:45 FAX Q001/001 • <br /> . n • <br /> • .. • JU TSDICT JON i O E YOUR CHOICE . : . <br /> ...BUILDIN DEPART N'T • • <br /> • <br /> . ' . . RE: permit # l O 14 . • • . . 9/17/07 . <br /> Inspec Affidavit • • . <br /> C.,, . <br /> • <br /> I «..: i c _ �� (��'' • T lic ensed`as a(n) Contractor* /Engineer/Architect <br /> . . (please print name and circle Lic. Type) - : TS 468 Building Inspector* . <br /> License #; C - - U ` � ,; ' -- 1 • • <br /> . On orabout `:� 1�L , 1(o Z• C7 ► C - , I did personally inspect ro <br /> • �_ (Dail '- • • • <br /> de 'na ilinr.and/o r sec wa barri& wor at '� c' '' . <br /> `"--_ -(ei Je_one,) ` ..__- --�'': (job Site Address) • <br /> Based • . u. < t examination I have determined the installation was done according, to the - <br /> . H .: - 4`i: gation Retrofit Manual (Baled on 553.844 F.S.) ' <br /> I.. - <br /> -�- N <br /> Signla•� . . . <br /> . . STATE OF FLORIDA • <br /> • COUNhY OF : .cam t U <br /> • S`worntd and snb0Gnbed before me this ! :fa day. of — J ' 1. .{ ;200--,._ . <br /> By ,�_ • <br /> No of F onda_: _. <br /> . ' tart' P!?b..]3N. . <br /> i _ 0 ,,,,,,,, SUZANNE DOLiGLks -ALLEN <br /> i . ` 1 ;'. ,si , r.o ,, Notary Public • State of Florida <br /> . ! C ' r Ay Ca- eri,,c: ^^ C. r "" art 2 9 0 11 <br /> ( r X4 _ 1..• ion ?' 0D714319 <br /> .. %'>`o�.o;'' BondedThroucinNa Notary Assn, <br /> ' � -. S ` <br /> Personalty known . ` or I . <br /> Produced Identification <br /> • <br /> Type of identification produced. • . . <br /> * General, Building, Residential, or Roofing Coahacier or any individual certified =de 468 F.S. to male such an <br /> inspection. Include photographs of each pied of the roof with the permit # or address # dearly abowli marked on the . <br /> deck for each inspection. <br /> ZANNE DOUGLAS- ALIEN <br /> f <br /> r. ,:ary Public - State of Florida <br /> ,. ,c;nrrssion Expires Oct 25, 2011 <br /> y ,� � Commission 1r 0D714319 <br /> Il :' BondedTnro,,,gri N7,tional N- . Assn <br /> . <br /> • <br /> • <br />