RF-02-20-305 (1)Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RE: Permit # DATE:
INSPECTION AFFIDAVIT
n
I _ E:c�a:AO licensed as a (n) Contractor / Engineer / Architect,
(Print name and circle License Type) FS 468 Building Inspector
License #: 00 22$3
On or about + I b' -&D 11 ' 00 4 n
(Date &
work at 22,:::) 0 `v Its "Tc'e..
Based upon that exami
Manual (Based ar
State of Florida
County of Dade:
I did personally inspect the roof deck nailing
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(Complete Job She Address)
determined the installation was done according to the Hurricane Mitigation Retrofit
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 i� day of tYl
Notary Public, Sate of Florida at Large ofFlorldo
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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 # dearly shown marked on the deck for each inspection