144 Sable Palm Ct - 08-000920 (2008) INSPECTION AFFIDAVIT - ROOFRE: Permit
t
Inspection Affidavit
I "2/eL i ,licensed as a(n) ontractor /Engineer/Architect,
please print name and circle Lic. Type) FS Building Inspector*
License #; CCC l,3 28626
On or about /d " — m , I did personally inspect the roo
Date & time)
de nailinan secondall water barrier work at 1W S,D/Q
circ (Job Site Address)
S w. rat /, )L 3 Z. 7 7
Based upon that examination I have determined the installation was done according to the
Hu M, ati R ro (Based on 553.844 F.S.)
Signature
STATE OF FLORIDA
COUN Y OF \,
Sworn and subscribed before methis.day of O(`OV r 200
By i
1CS`t&otne
1FQr:
ELHONo"v.;' P,YCOMMISSION #
DD675506 0_N TO(
REBOTErH'EXPIRES May 1'62011 6 ayIY'(, MMISSION #
DD67550Ne
cexom
PiRES 011M16,2(407) 398•D153
FloridallotarySe CommissionNo.:
Personally known or Produced
Identification Type
of identification produced.
bCNkCS 1,
5( ;AU 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.