RF-02-23-284 Inspection Affidavit 388 NW 111 TerrPermit # RF-02-23-284
Miami Shores Village - BUILDING DEPARTMENT
10050 NE 2 Ave Miami Shores, FL 33138
305-795-2204 www.msvfl.caov
DATE: 03/21/2023
I SPECTION AFFIDAVIT
i�licensed as a(n) Contractor /Engineer /Architect,
(Print name and circle License Type)
License #: ��
On or about 03/21/2023 , I did personally inspect the roof deck nailing
work at "-�e�yktime
(Complete Job Site Address)
rasedpon that exa ination I have determined the installation was done according to the
e Mitigatiion R ir on 553.844 F.S)
S)knature
State of Florida, Miami Dade County:
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 03 day of 21 _/ 2023
ur&A,a aNAHMk pro
Nobn Notary Public, State of Florida at Large. I F
For Forms and Applications click here:
http://bldg.miamishoresvillage.com/WebLink/Browse.aspx?id=118080&dbid=0&repo=Mia
mi5horesVillage
Rev01 142021 Inspection Affidavit Page 1 of 1