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City of Oldsmar Roofing Permit Inspection Affidavit

  1. Inspection Affidavit

  2. I, _________________________________________________________

    Print qualifier's name

  3. licensed, as: check your professional title

  4. License No:_______________________________________________

  5. On or about

    Date: ___________________ Time:___________________

  6. I did personally inspect the:

    Check all that apply

  7. at the property address of

    _________________________________________________________________________

  8. Being appropriately licensed to conduct this work, and based upon the examination of such work, I have determine that the installation was done according to the Hurricane Mitigation Manual (Based on 55.844 F.S.)

  9. Signature: ___________________________________________________

  10. Date: _____________________________

  11. Leave This Blank: