RF-03-19-549 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 # i� - O3- 0 - 5 H 9
INSPECTION AFFIDAVIT
DATE: K
,�q b .1
i v�.� ftio�. i � licensed as a Contractor Engineer / Architect,
(Printns=and drdsLicense Type) FS 468 Building Inspector
License #: M 133 i -7 640
On or about 4 L.9 114 , I did personally inspect the roof deck nailing
Palo 3 tlme)
work at_L3LW'*let I'Pijo2e S. F�- 3313�'
(Complete Job Sh Address)
Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit
Manual (Based on 553.844 F.S)
Signature
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.
Sworn to and subscribed before me this day of ' L 0-019
NotaryPublic, Sate of Florida at Large ,.;;: KELLY POCKLINGTQN
State of Florida -Notary Public
•= Commission a GG 149830
=%= My Commission Expires
October 09, 2021
'General, Bul AI, Resldentlal, or Rooft Contractor, or any IndNidual cedthd under 468 F.S. to make such an inspecam, nduda o raphs oI aavh plane of the roof with
permlt Al and address 0 deerly shown marked on the deck for each Inspection
Pe -I..q — (711 nnn l F 5C n 1 YMi14