RF-18-1220 (2)RE: Permit # g F S -18 - l z z o
iami ShoresViiiage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
DATE: O /2- l8
INSPECTION AFFIDAVIT
I Eri cfr- A • n C1/4,
(Print name and circle license Type)
License #: Cc.[_ — (3 3 t 2 q'-
On or about o""l«li 0 /of 30 aM
(Date & time)
work at f `1 Z 1 Kir ! D3 µian� t G‘,ora$ 1 g'L 33 / 3 8 .
(Complete Job Site Address)
Based . ion that; examination I have determined the installation was done according to the Hurricane Mitigation Retrofit
Manu..l (B..ed on 553.844 F.S)
licensed as a (
FS 468 Building Inspector
ngineer / Architect,
Sig ature
, I did personally inspect the roof deck nailing
St.te 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 0 7 day of Pr ao 0
I t—�
Notary Public, Sate of Florida at Large o1-cw'4, C Ion 02-e—S
LAUREN Chi ST NE TC: _
Notary Public - State of
Commiss.oi CC •_�y;
My Comm. Exoi•es Seo :3. 202"
8crded through Naticral Ncter; Assr
*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