RF-18-197 i
SNORES Miami Shores Village
sell ,.,..M Building Department
1.0050 N.E.2nd Avenue
a��— ped Miami Shores, Florida 33138
�ORIDP` Tel: (305) 795.2204
Fax.; (305) 756.8972
RE: Permit#_I " 197
DATE: 4-
INSPECTION AFFIDAVIT
I ()6L-vr�h�t'v� licensed as a (n) Contractor/Engineer/Architect,
(Print name and circle License Type) FS 468 Building Inspector
License#: S 7
On or about d' ,I did personally inspect the roof deck nailing
(Date&time)
work at AJ S`!—
(Complete Job Site Address)
Based upon that eXamin6ti6b I have determined the installation was done according to the Hurricane Mitigation Retrofit
Manual(Based on 533.844 F.S)
Sign t re
State of Florida
Eounty of Dade:
The undersigned, being the first duiy sworn, deposes and says that he/she is the contractor forthe above property
mentioned.
Sworn to and subscribed before me this 1' day of _
MONALISA GIPSON
Notary Public-State of Florida
Notary Public, Sate of Florida at Large _ commission# FF 96421 t
OF FMy Comm.Expires Mar 27,2020
Bonded through National Notary Assn.
'General,Building,Residential,or Roofing Contractors or any indl uat certified under 468 F.S.to make such an inspection.Include photographs of each plane of ft oroof with
permit#and address#dearly shown marked on the deck fore h inspection
uoa�o,��.,r71tif1f9r11A\F1911')MO