RF-10-679 (2)RE: Permit # "'' (.0/1
INSPECTION AFFIDAVIT
DA el- 0 0444 E 1 1 licensed as a (n ; Contra ' r / Engineer / Architect,
(Print name and drde License Type) FS 468 Building inspector
License # . a 6') 1 9 0
On or about 6I ° 1 10 t ( , I did personally inspect the roof deck nailing and
(Date & ffioe)
Secondary water barrier work at r 10 I(E _ q4 (4i ( 1 LS 1 . 313 g
(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
State of Florida
County of Dade:
The undersigned, being the first duly sworn, deposes and says that he /she is the contractor for the above property
mentioned.
Swom to and subscribed before me this ag day of I�ll lf�,rg0i
Notary Public, Sate of Florida at Large
Revised on 6/21/2009
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Building Department
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DATE: le I 1 0
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*General, Bugg, Residential, or Roofing Contract= or any individual certified under 468 FS.. ��t� �itu Ographs of each plane of the roof with
pemdt# and address # dearly sham marked on the deck for each hhspeefiah'f, ✓ ' • . . ,� S �