RF-01-23-235 Inspection Affidavit 1050 NE 105 StPermit # RF-01-23-235
Gabriel Matos
Miami Shores Village - BUILDING DEPARTMENT
10050 NE 2 Ave Miami Shores, FL 33138
305-795-2204 www.msvfl.gov
DATE: 03/03/2023
INSPECTION AFFIDAVIT
(Print name and circle License Type)
License M CCC1329249
On or about 03/03/2023
licensed as a(n) Contractor / Engineer % Architect,
I did personally inspect the roof deck nailing
(Date & time)
work at 1050 NE 105 ST, 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
.ate 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
3rd
day of March, 2023
E—
GG s232n+
Notary Public, State of Florida at Large gyp,
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