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RF-10-23-2501 Inspection Affidavit 9825 NE 7 Ave
Miami Shores Village - BUILDING DEPARTMENT 10050 NE 2 Ave Miami Shores, FL 33138 305-795-2204 www.msvfl.gov Permit# E�— f0"Z-3"Z5O1 DATE: (/ f z7zZ-3 INSPECTION AFFIDAVIT A bdi az S / z (Print name and circle License Type) licensed as a(n) Contractor / Engineer / Architect, License #: GGC / 2 3 ©��[ On or about�4z3 1 did personally inspect the roof deck nailing (Date & time) rr work at � Ave (Complete Job Site Address) Based upo amination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S) Signature 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. Sworn to and subscribed before me this day of � � � Z00-5 Notary Public, State of Florida at Larger + Notary Public State of Florida Ned loedo Reyes My Co Cornmiasion For Forms and Applications click her Exp. 2r7r2026 http://bldg.miamishoresvillage.com/WebL!nk/Browse.aspx?id=118080&dbid=0&repo=Mia miShoresVillage Rev01 142021 Inspection Affidavit Page 1 of 1