RS-17-1322iami Shores Vinage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RE: Permit # I2— '"r 1-1— l 2Z DATE: 1 (-1 it 1
INSPECTION AFFIDAVIT
tP\t__tI\C'E:7cL) licensed as a (n) Contractor / Engineer / Architect,
—T
FS 468 Building Inspector
(Print name and circle License Type)
License #:
C\005eitta
On or about � / �" / , I did personally inspect the roof deck nailing
(Date & time)
work at / ()(p k LE ICJ
(Complete Job Site Address)
Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit
Manual Based on 553.84 F.S)
Signature
State of Florida
County of Dade:
The undersigned, being the first duly sworn, deposes and says that he/she is the contractor for the above property
mentioned.
Sworn to and subscribed before me this d
I •.•;gf' ,, PAOLA BASSI
Notary Public • State of Florida
Notary Public, Sate of Florida at Larg '
; " �` Commission # FF 966918
%;; ; �d;'My Comm. Expires Mar 13, 2020
A
•
'General, Building, Residential, or Roofing Contractors or any individual certified under 468 F.S. to make such an inspection. Include photographs of each plane of the roof with
permit # and address # clearly shown marked on the deck for each inspection
r)ovicn�i nn 17111111111A \ ntIno
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
a- rt
RE: Permit # DATE:
INSPECTION AFFIDAVIT
l licensed as a (n) Contractor / Engineer / Architect,
(Pre( name and cid b Leena Tyrol
License #:
FS 468 Building Inspector
On or about I did personally inspect the roof deck nailing
(Delo a erne)
work at
(Complete Joe Site Address)
Based upon that examination 1 have determined the installation was done according to the Hurricane Mitigation Retrofit
Manual (Based on 553.844 F.S)
Signature
State of Florida
County of Dade:
The undersigned, being the first duly sworn, deposes and says that he/she is the contractor for the above property
mentioned.
Swom to and subscribed before me this day of
Notary Public, Sate of Flodda at Large
General SAN. Residential, or Roofing Contactors etany individual certkd Limb, 468 F.S. b maw such n inspection. hdude phdbtrephs d each Wane or to roof web
penia tend address t tleery even marked m to deck ler each Impaction
116.16 6Am /11111,111..P1 I MI.