RF-17-2440 (2) % 5�`°R s Miami Shore's Villa e
9
logo loll,» Building Department
10050 N.E.2nd Avenue
Miami Shore`s, Florida 33138
ion Tel: (305) 795.2204
Fax: (305) 756.8972
RE: Permit#_l-F-ld- IT eM Ll) DATE: �� • �� ' �%
' INSPECTION AFFIDAVIT
I
licensed as a Contract Engineer I Architect,
(Print name and circle License Type) FS 468_,Building Inspector
License#:
On or about /6 •/6 26/ 2••OD �/Lj , 1 did personally inspect the`roof deck nailing
(Date 8 time) }
work at P a'(/
(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.
Sworn to and subscribed before me this day of
Notary Public, Sate of Florida at Large
,'�`• �;; SANDRA ANN BUSTA
*i * MY COMMISSION#FF 159120
EXPIRES:September 14,2018
bonded Thru Notary Public Underwriters
*General,Building,Residential,or Roofing Contractors or any Individual certified under468 F.S.to make such an inspection.Include p
t
permit#and address#clearly shown marked on the deck for each inspection
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