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2. Roofing Inspection Affidavit
4. City of Zephyrhills
   5335 8th Street, Zephyrhills, FL 33542
5. Phone: 813-780-0020
7. Permit Number
9. Name
11. I am licensed under Chapter 468, Florida Statutes as a(n):

    1. Architect

    1. Building Inspector

    1. Contractor

    1. Engineer
13. License Number
15. Personal Inspection Date
    Personal Inspection Date
16. I personally inspected the:

    1. Dry in

    1. Flashing and Drip Edge

    1. Roof Deck Nailing
18. Check which was used:

    1. 30 Pound Felt

    1. Peel and Stick

    1. Other
20. If other, please explain:
22. Address of Roof Inspection
24. Based upon that examination, I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on Section 553.844, Florida Statutes).
26. Signature
28. State of Florida
30. County of Pasco
32. Sworn to & Subscribed Before This Day
    Sworn to & Subscribed Before This Day
33. Notary Public State of Florida
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