RF-17-2351 (3) S�ORFs <
Miami shores V
n� sliest" Building Department
10050 N.E.2nd Avenue
�tieNrag I Miami Shores, Florida 33138
ORiDp Tel: (305) 795.2204
Fax: (305) 756.8972
RE: Permit# r'r 0 q ` �✓ -J S /
DATE. /
INSPECTION AFFIDAVIT
licensed as a(n) Contractor/Engineer/Architect,
(Print name and circle License Type) FS 468 Building Inspector
License#: ML I X7)2,0-1 3
On or about 81--�0 11-1 - , 1 did personally inspect the roof deck nailing and
(Date&time)
Secondary water barrier work at
aqcl �Jv--- qq-
(Complete Job Site Address)
Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit
Manual (Based on 553.844 F.S)
4
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
r
mentioned.
Sworn to and subscribed before me this day of
-- uvr Nj(L—
PJOANNE KNESKI
Notary Public, Sate of Florida at Large ,o
_ * . of Florida
My Comm.Expires Oct 9,2018
Commission #FF 131532
'General,Building,Residential,or Roofing Contractors or any individual certify d und0468 F.S.to Make su an inspection.Inclu e p otographs of each plane of the roof with
permit#and address#clearly shown marked on the deck for each inspection
Revised on 5121/2009