RF-18-137 (2) w.�
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1 ,5>�ORES
,xC.13s Miami Shores
Village
f .Big Building Department
ent
10050 ME.2nd Avenue
Miami Shores, Florida 33138
lOR1Dp' Tet: (305) 795.2204
Fax: (305) 756.8972
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RE: Permit# YZ F 1- 18^ 131" DATE:-3))4 41R
INSPECTION AFFIDAVIT
I Lov I S -TUMV n licensed as a(n ontractor ngineer/Architect,
(Print name and circle Licens"e Type) FS 468 Building Inspector
i
License#: (!CSL LS 15 LfU 8
On or about 3� ►4�18 , I did personally inspect the roof deck nailing
(Date&time)
work at I DL95'i 06 I1 Av .
(Complete Job Site Address)
Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit
Manual(Base on 553.844 F.S)
a
Signatu e ,
` State of Florida z ,
County of Dade:
The undersigned, being the first duly swom,deposes and says that he/she is the contractor for the above property
mentioned.
I
Sworn to and subscribed before me this 141" day of M Q ren . 71)18
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Notary Public, Sate of Florida at Lar6 #09 19288
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� .�E,�,.J�Yrx Mph 6,2022
���ri,� tll P OinArm Will
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# '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#clearly shown marked on the deck for each inspection
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