Laserfiche WebLink
08/05/.2010 12:36 FAX 0001 /001 <br /> • . • • <br /> • : • C HOICE - <br /> • .JURISDICTION l O ' Y <br /> • B1 DING{ EPAlt NT - <br /> . • <br /> r 9/17!07 <br /> : Permit# ± Q 1 `er' • <br /> • tInspec Affidavit - - <br /> • . . . . . . • . <br /> • I (S_N-, - icensed as a(n) Contractor /Engineer /Architect; <br /> TS 468 Building Inspector* (please punt name and circle Lic. Type) - <br /> License #; C CG 052) 1 3 - <br /> , I did ersonally inspect ran • • • <br /> On orabout e...., - l C� P - <br /> dec <br /> ec 'lin .and/or sec • , , 14; ater b • ' ' work at • 5 3 1 5 5 S <br /> _ (Job Site Address). . <br /> Z/h•t1s. • <br /> Based ..4n n e , t examination I have detemnined the installation was done according to the • <br /> • g - '' k`i: gation Retrofit Manual (Based on 553.844 F.S.) . <br /> rd <br /> Signs.. �' \ . <br /> , . STATE OF FLORIDA • <br /> COUNTY OF r Z� t (� <br /> • F� <br /> • Swomn and s$bscribed . before me this 5 day. of t-C C (A_ E T ..200... Q . <br /> • By \ • . <br /> �' : Notary Public, State of Florida <br /> \ • <br /> • ! ' ' , e of . v. , . ", of Florida <br /> �� . °s'•a ° •`,c,, Notary • . n <br /> r .., . _Commission <br /> m on il'rDD7 431911 <br /> Personally llnown. or <br /> Produced Identification - <br /> Type of identification produced. <br /> + General, Building. Residential, or Rooting Comnct r or say individual certif ed ceder 468 F.S. to make such as <br /> inspection Include photographs of each plane of the roof with the pamit # or address # clearly shown madded on the <br /> deck for each inspection. <br /> • <br /> • <br /> • <br /> . <br />