RF-06-20-1278 INSPECTION AFFIDAVITRE: Permit #9� db '.y0 - /.27
OSCAR RINCON
(Print name and circle License Type)
License #: CCC1331610
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
INSPECTION AFFIDAVIT
DATE: . �.
licensed as a (n) Contractor / Engineer / Architect,
FS 468 Building Inspector
On or about.13J ?/2^ I did personally inspect the roof deck nailing
(Date & time)
work at 873 NE 96 ST
(Complete Job She Address)
Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit
on 553.844 F.S)
State of Florida
County of Dade:
The undersigned, being the first duly swom, deposes and says that he/she is the contractor for the above property
mentioned.
Swom to and subscribed before me this day of 19,E ,
;+me, GUILLERMOPERU
ze, :"
�= MY COMMISSION S 00 24
Notary Public, Sate of Florida at LargeE EXPIRES: oecemb®ra, 2
OWN ThN kQW €+uhita l'
GUILLERMO PEREZ
';. MY COMMISSION # GG 247239
'General, BuIlding, Residential, or Roofing Contractors i9p I Bcoadffma�a�ry f'u�nde� Inspection. Include photographs or each plane of the roof with
permit # and address # dearly shown marked on the MA--