RF-10-23-2568 Inspection Affidavit 142 NW 100 StMiami Shores Village - BUILDING DEPARTMENT
10050 NE 2 Ave Miami Shores, FL 33138
305-795-2204 vYvvw._msVf1.q®y
Permit
DATE:
INSPECTION AFFIDAVIT
sJ k0-� Plt+-) _ _licensed as a(n) Contract r / Engineer/ Architect,
(Print name and circle License Type)
License #:
On or about
I did personally inspect the roof deck nailing
work at iE �" L /`� � at� 86 icm l �`lo re .
(Complete Job Site Address)
Based upo that examination I have determined the installation was done according to the
Hurricane � 'ti ation Retrofit Manual (Based on 553.844 F.S)
Signatur /
f 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. 1
Sworn to and subscribed before me this l day of
h� Notary Public State of Florida
Jeanette Garcia
Notary Public, State of Florida at Large �� iiii;i "'YhiF�l a61bi0�ion
/2026
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miShoresVillage