RF-07-20-1590 INSPECTION AFFIDAVITMiami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RE: Permit #
INSPECTION AFFIDAVIT
DATE: D 12- -� ?-0
licensed as a n ntra t
�� _. _ O c a Engineer / Architect,
(Print name and circle License Type)
FS 468 Building Inspector
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License #: L
On or about �'
I did personally Inspect the roof deck nailing
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(Date 8 time)
1 work at %o _ N E, It) �-
(Complete Job Site Address)
Based upon that examination I have determined the installation s done according to the Hurricane Mitigation Retrofit
Mpny� (Based on 553.64 F.S)
Signature
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. , r, arrttando'�de
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Sworn to and subscribed before me - fxp def+�f1rofxotary $112,10)
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Notary Public, Sate of Florida at Large "tL) ,
'General, Building, Residential, or Rooting 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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