PERMIT DOCUMENTS I'r .
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City of Boyntoneach
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Building Division
*This • --% - - ' - d from November 1, 2005 until February 28, 2006
LICENSED ROOFING CONTRACTOR
AFFIDAVIT
ROOF METAL & ROOF SHEATHING INSTALLATION
(EXISTING ONE & TWO FAMILY DWELLINGS ONLY)
The City of Boynton Beach offers progressive inspections — call 742-6355
To: City of Boynton Beach, Florida
Department of Development - Building Division
Field Inspection Section
100 East Boynton Beach Blvd., PO Box 310
Boynton Beach, FL 33425-0310
Re: Permit No. 006'000 70 XW
From: ��kcy Vlomgf fliutyl £vI/I£"- ,..-c (Contractor)
9 ) rel )//f.P Red, IA: /a ,C/. 335!g 1 (Contractors Address)
14in,, —✓ .aoi r - (Owner/s Name)
/9 4&v77aign.P !'.Rr#• Zoe75A/ Ac/i. i C/. •??V,,)/(Property Address)
CERTIFICATION SELECTION: (Please check all that apply)
❑Certification of roof metal installation, flashing, underlayment.
Certification of re-nailing roof sheathing, and removal and replacement of damaged or rolled wood.
Other
per
I, r6- Ei 1/1.lr1pi- - , am certified as a roofing contractor (License No.
and o hereby certify that all roof work (as indicated above) has been performed
at the above address in accordance with Chapter 15 of the 2004 Florida Building Code, Existing Building, as
amended, and Manufacturer's Specifications. I understand that the City of Boynton Beach offers progressive
re-roof inspections. I have notified the owner of the property of this affidavit. I will provide pictures of the re-
nailed, repaired roof sheathing, roof structural members and roof metal to the inspector.
Signature / Date s 13 +U�
STATE OF FLORIDA, COUNTY OF PALM BEACH
The foregoing instrument was acknowledged before me this -7 / 4 (date)by kI ,• o_ti u ,who
is_personaIly known to me or who has produced (type of identification)as id tification -
and who did (did not) take an oath. \ 1 f • — — — — pin
Signature of person taking acknowledgement(' / c ``''
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Name of officer taking acknowledgement--typed, printed or stamped If _ 7 .: •• - • 2pp7
— _ ,._ % Cbornli °•co2726i2
Title or rank Serial number
100 East Boynton Beach Blvd, PO Box 310, Boynton Beach FL 33425-0310 Phone: (561)742-6350 Fax: (561)742-6357
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ACity of Boynton Teach
iP� Building Division
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ROOF METAL & ROOF SHEATHING INSTALLATION CERTIFICATION
(EXISTING ONE & TWO FAMILY DWELLINGS ONLY
FOR LICENSED ROOFING CONTRACTORS ONLY
PURPOSE
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.
II. AUTHORIZATION
Section 104.6 of the Boynton Beach Amendments to the 2004 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
2004 Florida Building Code, and Existing Building Code, as amended, and the manufacturer's
installation instructions.
This affidavit must be presented to the inspector at the next scheduled inspection on-site or
sent to the inspection office along with applicable pictures.
When the roof metal and roof sheathing are not inspected at either a Sheathing, Tin Tag/Roof
' Metal, or Final Inspection, the Structural Building Inspector will either fail the inspection until
certified by the applicant or pass the inspection if the signed affidavit is present at the job site.
Pictures of the re-nailed and repaired roof sheathing and roof metal are required.
When a Final is the only scheduled inspection and an affidavit is supplied, the Inspector shall
add the comment, "CERTIFIED," and pass the inspection.
oge_ssGfe.re-ro Inspections may still be requested by calling the Inspection clerk 24
rrafduo>t>ms+m rior fat (561) 742-6355.
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100 East Boynton Beach Blvd,PO Box 310,Boynton Beach FL 33425-0310 Phone:(561)742.6350 Fax:(561)742.6357
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