RF-18-1069 4
' gOIR
.5�x�113= Miami shores Village
..,. Building Department
10050 N.E.2nd_Avenu'e
Miami:Shores.Florida 33138
�LORiDA' Tel: '(305) 795.2204
Fax:'(305) 756.8972
AFFIDAVIT OF COMPLIANCE WITH ROOF.TO WALL CONNECTION HURRICANE MITIGATION
RETROFIT FOR EXISTING SITE-BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES PURSUANT`
TO SECTION 553°.844 F.S.
To: Miami Shores Village Building Department Date:
10050 NE 2nd Ave
Miami Shores, FI 33138 ,
Re:. Owner's Name: %C.01Ci1' t
Property Address:: . 1 wo l 1`1 La YY1► ,a\/e
Roofing PermitNumbe.r:
Dear Building Official:
i �C7U'► 0 certify that 1:have improved the roof to wall.connections of the referenced
property as required by the Manual of Hurricane Mitigation'Retrofits for'Existing'Site=Built Single Family Residential
Structures as adopted by the.Florida Building Commission by Rule 98-3.047 F.A.C.
Signature Print Name
I
State of Florida
County:of Dade
The:undersigned,being the first duly swom,deposes and says that he/she;is the owner for the above property mentioned.
Sworn to and subscribed before'me this Ill day of_ N 20r
f
Notary:Public, Sate of Florida at Large .
0, ,MISS�
mBER
(SEAL) - G FF 932615EXPIRES
Revised on 5/2172009 r�
1