RF-17-1847 (2) OR$g LSC
� py 10050 NE 2nd Ave
FLOFt1p Miami Shores,FI 33138
Phone 305-795-2204; Fax 305.756.8972
{ www.miamishoresvillage.com
RE: Permit# AF--�'rf+ -1?y-+ Zd1:+
DATE:
i INSPECTION AFFIDAVIT
I cawle SGOT licensed as a (n Contractor)
ontracto)Engineer/Architect,
(Print name and circle License Type) FS 468 Building Inspec or
License #: C CC 32 6
S
On or about q C1 I did personally i et th of deck nailin a d/or
(Date&time)
secondary water barrier work at I 1 0 /VE 01 7—e—fra Ce-
(Complete Job Site Address)
Based upon that examination I have determined the installation was done according to the Hurricane_
Miti ion Retrofit Manual (Based on 553.844,F.S),,
Signature
State of Florida
County of Dade:
Theundersigned, being the first duly sworn, deposes and says that he/she is the contractor for the above
property mentioned. i
Sworn to and subscribed before me this
&014sf cinthia Bennett
day of NOTARY PUBLIC
' o STATE OF FLORIDA
?Comm#GG072516
Notary Public, Sate of Florida at Large ��"El Expires 2/13/2021
*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