RF-16-1678 (2) ops
Miami shores Village
Building Department
$ 10050 N E 2nd Avenue
Miami Shores. Florida 33138
�ORtNp' Tel: (305)795 2204
Fax: (305) 756 8972
R Permit# DATE
INSPECTION AFFIDAVIT
I S VO4 Tap QMpT40 6 LL C licensed as a(n)Contractor 1 Engineer t Architect,
name anc Ora J06M Tyx+ FS 468 Building Inspector .
License GCC-- 13?_9 3*7.3
On or a ;gut 2 2—jo t did personally inspect the roof deck nailing
work at ,S Z?:>Cr _g 7 ST
1Corn0ek.00 Sft Adma)
Based u;: n that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit
Manual t6ased on 553.844 F.S) State of Florida
�> County of Miami—Dade
Sworn andubscribed before
me this t s'Day of20 /�
Signatj
ID: FL CD #
R241 101 61 124 0 otary u
State o` o��da .L
MYCOWMCUEEMW
County of Dade: nREn�nr 14,2017
eo
U*Mbm
The undersigned, being the first duly sworn,deposes and says that he/she is the contractor for the above property
mentioned
.
. ••• • • • • ••
Sworn tc aid subscribed before muftis s��: _ : : :d4y of 5UNC I C�
• •• • e i • ••• • 1
•• ••• • • • ••
Notary Pubi c, Sate of Florida at Large ,�" E
•a pro.
• +s67V
• • 6
• • • • • • • • • •
'rsa,•d?2: 5,..• RCSOCnt8r 3'Rxfrx,COffttaf26Y8 a deflfied• i�,to rn*e s,;0 an MKC1f+ -,Qua pho*grapbs of earn Rune e"e'OM Will
wt a a : -:s s.ea^r VW narked a`v*heck for aw mspecwt