RF-03-22-569 INSP AFFIDAVITMiami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RE: Permit # ' d�- zy- / DATE: 0112512022
INSPECTION AFFIDAVIT
I Daniel Gonzalez-Lauzan licensed as a (n) Contractor / Engineer / Architect,
(Print name and circle License Type) FS 468 Building Inspector
License #: CCC1328913
On or ahoLlt I did personally inspect the roof deck nailing
(Date & time)
work at 321 NE 93 St
(Complete Job Site Address)
Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit
Manual (Based on 553.84 S)'
Signature
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 25 day of 01"L
NotaryPublic, Sate of Florida at Large Notary Publlc State of Florlda
g ►k Anaifyn Estrada
L r HH212694f°"
Exp. 1/10/2026
'General, Bullding, 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
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