RF-16-2764 (2) Miami Shores Village
Building Department
10459 Id.E.2nd Avenue
Miami Shores, Florida 33138
Tei: (305)795.2204
Fax:(305)756.8972
RE:Permit#i Fes- `l` `� y DATE. /
INSPECTION AFFIDAVIT
( licensed as a(nContractor/ ngineer/Architect,
{Print natrx►:attid circle License Type) FS 468 Building lnspec or
License* C'CG / _7 /
On or aboutZ 6 I did personally inspect the roof deck nailing
(tie&tkne)
work at /A0 -A)i- /02 5
(CwVeW,aob Site Address)
Based upon that examination l 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.
Sworn to and subscribed before me this_ / day of o4-, .�2 p .�
Notary Public,Sate of Florida at Largeo YIPS,
,o
NICOLE DIODATI
Notary Public-State of Florida
�=My Comm.Expires Feb 19,2017
'General,Bud",Residential,or itoating Canbatteors or sDY kUdualwgied under468 F.S.to make such �AI
Permit#and address#dearly shown marked on the deck for each inspection. R% with