RF-13-2352 tMORES
MiamiShores. Village
tell ,,,,,M Building Department
10050 N.E.2nd Avenue
Miami Shores; Florida 33138
��ARIUa Tel:J305) 795.2204
Fax: (305) 756.8972
RE: Permit# DATE:
INSPECTION AFFIDAVIT
I V'l N b 'licensed as a n Contractor/Engineer/Architect
.int name and circle License Type) FS 468 Building,Inspector
License#: r
On or about 1 did personally inspect the roof deck nailing and
(Date&time)
Secondary water barrier.work at �E Q St LL � 3,3
' ,3
8
. (Complete Job Site Address) °
Based upon that examination I have determined the installation was done according to the.Hurricane Mitigation Retrofit
Manual(Bas 53.844 F.S)
n re
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
Ai
mentioned..
Sworn to and subscribed before me this / day of
,a% LISSETTE PACHECO
Nota Public, Sate of Florida at Large
Notary Public-State of Florida
Notary Commissloniy;FF
nny CommaE237998
xpireS Jun
8.2019
_ 80ndedthrou9h National rVotar s<.•
'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 root with
permit is and address#dearly shown marked on the deck for each inspection
Revised on 5/21.2004