RF-07-20-1596 INSP AFFIDAVITMiami Shores Village
Bdiding Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RE: Permit #. BF-07-2O-1596 DATE: B-17-20 ,0
INSPECTION AFFIDAVIT
I Paul Bange licensed as a (n) Contractor 1 Engineer! Architect,
(Pdntname and cirdeLicense Type) FS 468 Building Inspector
License 4:._ QCCQa3-691^
On or about 8-17-2020 1 did personally inspect the roof deck nailing and
(Dale & lime)
Secondary water ban-ier work at 9876 NE 12th Avenue, Miami Shores, FL 33138
(Complete Job Site 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 helshe is the contractor for the above property
mentioned.
Sworn to and subscribed before me this 1 Zth /da of Auust. 202Q_
JILL .,IULLY
Notary Public, Sate of Florida at Large _ ft�coi EXPIRES:
;� s�sc3a
.i cr ,._•_.
Gnmi -� T!, o (:, „, P_b'ic Undan+niters
'General, Building, Residential, or Roofing Contractors or any individual certified under 468 F.S, to make such an inspectiom include photographs of each plane of the roof with
permitll and address ,Y clearly shown marked on the deck for each inspection
Revised on 5121 009