RF-18-1102 5NOR@S
Miami Shore's Village
Rome Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305)795.2204
Fax: (305) 756.8972
RE: Permit# DATE' S 2
� � h .tr
INSPECTION AFFIDAVIT
licensed as a (n) ontract r/Engineer/Architect,
(Print name and circle License Type) FS 468Building Inspector
License#: C-CC\`�Z-`' fn 6"-�
k
i
On or about d o )2,30- 1 did personally inspect the roof deck nailing
(Date 8 time)
work at h S �\3 ';i— ':�\m S k
,(Complete Job Site Address)
Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit
Manual (Based ori 553.844 F.S)
Signature i
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
mentioned.
Sworn to and subscribed before me this Z"' day of
Notary Public, Sate of Florida at Large �- C�'—'� :`'tea"° SANDRA M GARCIA
MY COMMISSION#FF134005
a
?e�FFop EXPIRES July 15,'2018
(407)398-910,3 FiyricinNeta Scrvice.com
'General,Building,Residential,or Roofing Contractors or any individual certified under 468 F.S.to makes a roof with
permit#and address#dearly shown marked on the deck for each inspection
0-4-4 rninM4A%rn4nnn0