RF-06-20-1160 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
(Print name and circle License Type)
License #:
On or abou
work at
(Date & lime)
(Complete Job Site Address)
DATE:
licensed as a (n) Contractor / Engineer / Architect,
FS 468 Building inspector
I did personally inspect the roof deck nailing
Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit
Manual (Based on 553.844 F.S)
f
Signatur
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.
Sworn to and subscribed before me this 23 day of 0� y
:' _ .ui:rv�uLLr. aalcot�lri:t:
Notary Public, Sate of Florida at Large
'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
ACB2 Engineering Inc.
Engineering and Laboratory Services
5230 NE 1811 Avenue
Fort Lauderdale, Florida 33334
Phone: (954) 245-8976 Fax: (954) 301-7776
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