108 Oaks Ct - 08-002161 (2008) INSPECTION AFFIDAVIT9
RE; Permit :# V
Inspection Affidavit
IIj,-eiti i y)Wk licensed as a(n) Contractor* /Engineer/Architect,
please print name and circle Lic. Type) FS 468 Building Inspector*
License #;. C 6 Z Z,C 0%
On or about .l, I did personally inspect the roof
Date & time)
f
decknailing and/or secondarywater barrier work at
circle one) (Job Site Address)
g p . SG T C: 7, A, P J 31 7 71
Based upon that examination I have determined the installation was done according to the
Hurricane M' 'gation Retrofit Manual (Based.on 553.844 F.S.)
CSig tures,
STATE OF FLORIDA
COUNTY OF
t Swoand b bed
a ..
y
WV Notary Public state of {Tori¢
Paul A Olesen
My Commission DD5*29
Expires 0210912010 . 61
Personally known -4— or
Produced Identification
Type of identification produced.
this day of 200
Notary Public, State of Florida
Print, type or stamp name)
Commission No,: DD lc [ G
General, Building, Residential, or Roofing Contractor or any individual certified under 468 F.S. to make such an
inspection. Include photographs of each plane of the roof with the permit # or address # clearly shown marked on the
deck for each inspection.