PERMIT DOCUMENTS City of Boynton Beach
71 •
Building Division
LICENSED--ROOFING-CONTRACTOR
• /' :. , AF:Fa ®A•,� fl
ROOF METAL & ROOF SHEATHING INSTALLATION
(EXISTING ONE & TWO FAMILY DWELLINGS ONLY).-4..
The City of Boynton Beach offers progressive inspections—call 742-6355
To: , City.of Boynton Beach; Florida •I :4 i , • , ,
Departmeht oWevelopment-.Buildmg,Division
Field Inspection Section • ' '
100 East Boynton Beach Blvd., PO Box 310
Boynton Beach, FL 33425-0310
Re: • . Permiald. f, 2: ( 7 : .,r. .
Froin: RL •`�. .,. t?G-J: FI /U ` L Contractor)"
21 S.4-).. 14'^. n : o 1' �/ y2.6.
( :, v�'v try/ / Contractor's Address)
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-S-1-k,/(e K ( (co" (Owner/s Name)
I l 0 a F(o R-e a f/ N.z U01 _.)
(Property Addiess
CERTIFICATION SELECTION:(Please check all that:app/y) .
E Certifsation of roof metal installation, flashing;'undedayment:
"Certifcation of re-nei ri roof sheathing, and removal and replacement of damaged'or rotted wood.
`iOther '17' n,t&' oLir; 3 51.4 i:. . . , ,.
pt c4A a oc(1 A \,1 A S , am certified as a roofing contractor• (License No.
cc ( 13 Z rf = ( and do hereby certify that all roof work (as indicated above) has been performed
at the,above. - -ss i :a . dance,..with Chapter.15 of'the,Florida-BuildingCode,' Existing-.Building, as
amended, - d . of- ..;r e .; ifications. I understand that the City of Boynton Beach offers progressive
re-roof in . - ion �.' no "fed t e,owner of the property,of this affidavit: .
Signatu,,:of Qual'ier Date -
STATEOF'FLORIDA?COUNTYOF:PALM BEACH ' •C- •y /�
The foregoing instrument was acknowledged before me this '7- 3-/ (date)by g� Gif and n 17 •!va
is personally known to me or who has produced 3 n L-`o., >-2 (type of identification)as identification
and who did (did not)take an oath. /n ' (SEAL)
Signature of person taking acknowledgement. -Uit U4{. A.. .�
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Name of officer taking acknowledgement—typed, printed or stampedt�/G .C
Title or rank No-Twit y. Serial numberoth,^�oMICHAELG.CUNU
MY COMMISSION q EE171A77
EXPIRES_F yy 23,2016
100 East Boynton Beach Blvd,PO Box 310,Boynton Beach FL 33425-0310 Phone:(561)742-6350 Fax:(561)742-6357
S:IDevelopmentleuildinglForms&TemplaleslRooringMetalBShealhinglnstallationPdicy&Aaldavit-1 B2family(12/99,12/02,1/03,1(/03,11/05,9/06,04/09)
City of Boynton Beach
� � Building Division
roN
ROOF METAL-& ROOF.SHEATHING.INSTALLATION CERTIFICATION
'. ` :(EXISTING:ONE&.tWO:FAMILYDWELLINGS.ONLY).
FOR LICENSED ROOFING CONTRACTORS ONLY
I: PURPOSE " ;
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The purpose of this Policy is to provide a method for certifying installation of roof metal, roof
underlayment and re-nailing of roof sheathing on occupied;or,finished one,and two family
dwellings. This policy applies only to licensed'roofing contractors:.
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II. AUTHORIZATION , .
Section 104.6 of the Boynton Beach Amendments to the Florida Building Code, Existing
Building, as.adopted by the City of Boynton Beach, provides that requirements necessary for
the;public safety, health and general welfare not specifically covered by 'the' standard or the
Building Official-shall determine other technical codes or policies. - .
III. APPLICATION,
Qualified applicants may certify the roof metal installation and re-nailing of roof sheathing by
preparing an affidavit certifying that the, installation of the roof metal,•and-re-nailing of. roof
sheathing- complies with .all codes, ordinances, rules and regulations;, that the .qualifier or
designee personally inspected the specific job; and that the roof was installed according to the
Florida Building Code, and Existing• Building Code, as amended; and the manufacturer's
installation iristructionsz
This affidavit must be presented to the inspector at:the next scheduled•inspection.on-site. •
When the roof metal and roof sheathing are'not inspected at.eithera°Sheathing, Tin Tag/Roof
• Metal, or-Final Inspection, the Structural Building Inspector will either-fail-the-inspection until
certified by the applicarit'or pass the inspection if the signed affidavit is present at the job site.
Pictures of the re-nailed and repaired roof sheathingand roof metal.are'optional.
When a Final is the only scheduled inspection and an affidavit is supplied, the Inspector shall
add the comment, "CERTIFIED," and pass the inspection.
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Progressive re-roof inspections may still be requested'by calling the inspection clerk 24
hours prior to re-roof at (561) 7424355.
100 East Boynton Beach Blvd,PO Box 310,Boynton Beach FL 33425.0310 Phone:(561)742-6350 Fax:(561)7424357
S:IDevelopmentlBuildingIFormsBTemplaleslRoofngMelalBSheathingInstallationPolicy8Alfdavil-182 family(12/02,1/03,12/03,11/05,9/06,03/09,04/09)