818 Escambia Dr - BR08-001068 - Inspection Affidavitr.,
m®
RE: Permit# 06' t?
Inspection Affidavit
I Li- k/ 1, MOCIk ,licensed as a(n) Contractor* /Engineer/Architect,
please print name and circle Lic. Type) FS 468 Building Inspector*
License #; C C 0 1 J' U
On or about ' < — f , I did .personally inspect the roo
ate & .t e)
eck nailing and/or secondary water barrier ork at (ba TI f1 •' Oe
e on (Job Site Address)
Based upon that examination I have determined the installation was done according to the
H . ' e M' ' t' n Retrofit Manual (Based on 553.844 F.S.)
Sig ture
STATE, OF FLORIDA
COUNTY OF
Sworn to/and, subscribed beforeme this lVday of 200L
By AMVQ.Ew _ Ayeoc.,t_
otary Pub l' SJ.e f Florida
Print; type or stamp name)
Commission No.:5 4y Ol
Personally known /or rPUo
Produced Identification gIf WILl_IAM C7' JCE WKIBBIN MY
COMM;'.,LION # DO 549018 Type
of identification produced.' k, ` EXPIRES: May 18, 2010 1-
800.3-140TV'Y F:- Notary Discount Assoc. Co. 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.