RF-17-2679 (3) l ,
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♦SOORE t
<< Miami ShoresW illage
Boom 111.1..1 Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
�gORtID�
Tel: (305) 795.2204
Fax: (305) 756.8972
RE: Permit#R-�- I ( ' -Z G-7-9 DATE: i
INSPECTION AFFIDAVIT
Miorika M Malinetescu
Y licensed as a (n ractor/ ngineer T Architect,
(Print name and circle License Type) FS 468 Building Inspector
I
License#: CCC 057535
r On or about Nov 2q ZQ i �j10r"n, , I did personally inspect the roof deck nailin
(Date&time) '
work at cJ l—�t� �s A
(Complete Job Site Address)
Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit
l Manual (Based on 553.844 F.S)
nature
f
State of Florida
r County of Dade:
The undersigned, being the first duly sworn, deposes and says that he/she is the contractor for the above property
mentioned.
6
Sworn to and subscribed before me this rt
_d y Of 2c� SIMONA LELUTIU
t +; MY COMMISSION#FF 154759
=",`•. a EXPIRES:August 26,2015
Notary Public, Sate of Florida at Large ` Aft;° sondodThruNota Public Un
Notary derwriterg
i
`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#dearly shown marked on the deck for each inspection
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