RF-02-23-512 Inspection Affidavit 1122 NE 98 St�oRcs Miami Shores Village - BUILDING DEPARTMENT
10050 NE 2 Ave Miami Shores, FL 33138
305-795-2204 iw►Fr w., i esy11'l.goy
O RIDp'
Permit # RFOZ 23512 DATE:
INSPECTION AFFIDAVIT
uww 1 aitck licensed as a(n) ontrac or / Engineer / Architect,
(Print nam nd circle License Type)
License #: CM U&239
On or about 41612z, 14:0o I did personally inspect the roof deck nailing
(D to & time)
work at bL 22 AE °(`x �,T NmAK, &orb
(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)
S ipiatu re
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 5
day of F ;l
04qNotary Public, State of Florida at Large u�
F,�
a N' W7P0Wie Stele of FFOnAt)dul MukiliMyCommissionHFi 127Q87
02f#712p25
��
For Forms and Applications click here:
http://bldg.miamishoresvillage.com/WebLink/Browse.aspx?id=118080&dbid=0&repo=Mia
miShoresVillage
Rev01 142021 Inspection Affidavit Page 1 of 1
tON-E -Mv
all.
lr�
;Ir
44r,
e
•
d
oa'� oQ o p •1�,
,'�o
0
•
Nomp..
Rb
e dp • r � a 4 a a�
In 4 d 41b .
w
s ++ ♦ 9 p 8� • o S
0 �v t
r a
�' 4 e ■ o
do 010
°` �'
•' .ir•--air �'�xC�r�''- t -�. - - - _
K� e -� - air •.� a ,� w �T as �a .. � !
�' s w o e w w • Q t:
' ,S er A o w lbA a O; 0
f s
-- A A A� ! d o a e y o v b e� R� Q
a d d A 0 e 4% 0 O IN,%
AV -OP go AV 40 a
e 146
a % a t
AV 4 4
� � R
�► v e Apo
�, ° ° e ■ s u e a
jr
v +�
,•i + * a R
ti
w 'W'p x 411 e 4 O d o a a C a t
S e Is!
p Y � la lb
Ar 'op op Q 430 R a ,1f
0 IP Q Q 0 Q Q
d. s Q amp Q s a qb
. �Ar e p o 4 v e ■ '� e�
v e $ ■ o �� w
A S AL :
�4
-Mwa.
�~ WAY
r ■ / ' ■ + Y •
rolp
jrr or
■ ■ •
c� r r ■ : ! ■ r • e y:
■dop
/ ■ • r
• + ■ �-