RF-04-20-738 INSP AFFIDAVITRE: Permit " 04 _ZO _
Ivan Gomez
(Print name and circle license Type)
License #: CGC1525739
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
DATE: 4/8/2020
INSPECTION AFFIDAVIT
licensed as a (n) Engineer / Architect,
FS 468 Building Inspector
On or about 4/8/2020; 2:30 pm . I did personally inspect the roof deck nailing
(Date & time)
work at 547 NE 94th St, Miami Shores. FI 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) r'
Signature 'J
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 8th day of_ April 2020
,4"0#'-Pe
Notary Public State of Florida
Notary Public, Sate of Florida at Large P""."W �- ���David C velasquez
David C. Velasquez'� My Commission GG 124357
Expires 07/16/2021
'General, Building, Residential, or Roofing Contractors or any individual cerfified under468 F.S. to make such an inspection Include photographs of each plane of the roof with
permit # and address # dearly shown marked on the deck for each inspection