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A <br /> • • . •JURI`SDI•CTIONjOF YOUR CHOICE <br /> • -.BUILDING {EPARTMENT - • ; <br /> RE: Permit# 10E,1 �! 9/17/07 <br /> Inspection Affidavit • - . - - • <br /> • <br /> rr ^ ) eer /Architect; <br /> • - I I c.l, \ < . jL \ l -4 " . v 7J ,li a(n Co ntr actor* /Fngin <br /> (please punt name and circleLic. Typ ! FS 468 Building Inspector <br /> License #.; C-CG 05 S 3 � . • <br /> • - On or about SE. P I (4, Z o f L` • , I did Personally inspect - the roo - . <br /> mate 8afitie) .. <br /> d •k n ailinz.and/or secondary water barrier , work at � J' 5 0 - I B ' <br /> • <br /> . -( circle.. grit)_ - _ - <br /> ...._ .............. . _._._ __- �J (Job Site Address) <br /> Based upo = "�.• t �', .... • tion I have determined the installation was done according to the • <br /> Hurricane i ■ • on Retrofit Manual Based on 553.844 F. S _) <br /> JO <br /> .......... ..., iv/ 4k . . • <br /> ► <br /> - Signature ; i . <br /> STATE OF FLORIDA Z v C; <br /> COUNTY OF r <br /> • Sworn. to and subscribed before me this 14 day. of ') E 1 'FE 11 fJ c l' . 2OO <br /> P <br /> - <br /> Notary Public, State of Florida <br /> ,,,,„,,., SUZANNE DOUGLAS -ALLEN <br /> ' * a of ommission ,'res • 3 , 2011 <br /> ' <br /> ;,, .47, Commission # 0D714319 <br /> 1 %;a,'.,,,,•. ,, ,I ,, National N . Assn.` • <br /> Personally known or <br /> Produced Identificatiorn i - <br /> . • Type of identification produced. - . • <br /> * General. Building, Residential, or Roofing Contractor or any individnal certified and 468 F.S. to make such an <br /> insp —tioa Include photographs of each plane of -the roof With the permit # or adders # dearly shown marked on the <br /> deck for each inspection. <br /> T00/T00121 XV3 ZS :8O OTOZ /6T /60 <br />