RF-01-23-65 Inspection Affidavit 10704 NW 2 AvePermit # RF
J o� �l��andeZ
Miami Shores Village - BUILDING DEPARTMENT
10050 NE 2 Ave Miami Shores, FL 33138
305-795-2204 www.msvfl.gov
DATE: 1I2-t(/Z3
INSPECTION AFFIDAVIT
(Print name and circle License Type)
License #: GLC 13115(01D
licensed as a(n(ontractor Engineer / Architect,
On or about ll zqlZ3 k-, 30 Qq , I did personally inspect the roof deck nailing
(Date & time)
work at 1010 t Nk) zu� 40C, 04*41' S%a�ts r fL 331G13
(Complete Job Site Address)
Based upon that examination I have determined the installation was done according to the
Hurricane MitigatioKRetrvfit Manual (Based on 553.844 F.S)
SiRr atLWe
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 2- day of ) CiPWO � v , 2-3
a�Y PUS OLGA L. SAEZ
r commission # GG 314168
A Expires March 19, 2023
Notary Public, State of Florida at Large i*17,p BondedThruBudgolNotary servims
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Rev01 142021 Inspection Affidavit Page 1 of 1