RF-09-23-2315 Inspection Affidavit 265 NW 91 StC rH.
—
tic,�r�s
Miami Shores Village - BUILDING DEPARTMENT
10050 NE 2 Ave Miami Shores, FL 33138
305-795-2204 www.msvfl.gov
Permit # RF 09 23 2315
DATE: 12-05-23
INSPECTION AFFIDAVIT
Raquel Porche licensed as a(n) Contractor / Engineer / Architect,
(Print name and circle License Type)
License #: CCC 1334865
On or about 12-04-23 at 9:00 AM I did personally inspect the roof deck nailing
(Date & time)
work at 265 NW 91 st ST, Miami, FL 33150
(Complete Job Site Address)
B e on tha a amination I have determined the installation was done according to the
urrIcan Miti ati n Retrofit Manual (Based on 553.844 F.S)
Sienat�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. ff
Sworn to and subscribed before me this day of
E
Notary Public, State of Florida at Large LA
�,y�+ Notary Public Slate of Florida
Clara Y. Contreras
Rely Commission HH 148741
or
Expires 471D5=6
For Forms and Applications click here:
http://bldg.miamishoresvillage.com/WebL!nk/Browse.aspx?id=118080&dbid=0&repo=Mia
miShoresVillage
Rev01142021 lnspc�ction Affi(ttoil Ililgc -1 of 1