RF-10-19-2321Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RE: Permit 4—LE— 1
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INSPECTION AFFIDAVIT
DATE: U Ito
9((hAt2LLA_ licensed as a (n) Contractor / Engineer / Architect,
(Print name and circle License Type) FS 468 Building Inspector
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License #: '-f' r ��
On or about I iltq "I'-60 01^' I did personally inspect the roof deck nailin
(Date 8 time)
work of I p 0v(?7v_
(Complete Job Site Address)
Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit
Manual (Based on �1.844 F,S)
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.
CATHERINEA.DUFFIN
r Notary Public - State of Florida
Sworn to and subscribed before me this day of = r Commission xpe5MaY14,2 Z'
__• .
My Comm. Expires May
A �F •= Bonded through National Notary Assn
ZC� I
Notary Public, Sate of Florida at Lar
'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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