PERMIT DOCUMENTS 0.. / 3 !
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o`C' : City of Boynton Beach
Ory O U
Building Division
LICENSED ROOFING CONTRACTOR
AFFIDAVIT
ROOF METAL & ROOF SHEATHING INSTALLATION
(EXISTING DETACHED 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. )1o'B i g+
From: hrtivamo Con ' uw Ituts (Contractor)
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6b 10o 16 7P� *Lehktil"t, 14 33'n° (Contractor's Address)
Odoa.Al4 M1IreN (Owner/s Name)
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13I Li 14 PAM, 1 , -41 (Property Address)
4CE TIFICATION SELECTION: (Please check all that apply)
ertification of roof metal installation, flashing, underlayment.
Certification of re-nailing roof sheathing, and removal and replacement of damaged or rotted wood.
20ther 54rNo LCS . ., 1 20"
I, /Srlttd!e'V R,(I RUL , am certified as a roofing contractor (License No.
I ) and do hereby certify that all roof work (as indicated above) has been performed
at the above address in accordance with Chapter 15 of the Florida Building Code, Existing Building, as
amendedd Manufacturer's Specifications. I understand that the City of Boynton Beach offers progressive
re-rooms.- fop . '3 ,- n; ified the owner of the property of this affidavit. I
At es. i ., /0 l a s l -2,0 w
Signature of Qualifier Date l I
STATE OF FLORIDA, COUNTY OF PALM BEACH (� D
T - •
• •T trument was acknowledged before me this I a/L7 h14 (date)by P raIN l t \l4 cAG , who
personal) own to me or who has produced /490Lota (type of identification)as identification
an. w o did(did not)take an oath. / , (SEAL)
Signature of person taking acknowledgement 1�1k1 .
Name of officer taking acknowledgement-typed, pried or stamped
Title or rank Serial number
r61-/�8000LA8
` "i Mr CONMISSroK a oc970989
EXPIRES Otiose 26.2019•
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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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City of Boynton Beach
titBuilding Division
toN O
ROOF METAL & ROOF SHEATHING INSTALLATION CERTIFICATION
(EXISTING DETACHED ONE & TWO FAMILY DWELLINGS ONLY)
FOR LICENSED ROOFING CONTRACTORS ONLY
I. 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 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 instructions.
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 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 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.
Progressive re-roof inspections may still be requested by calling the inspection clerk 24
hours prior-tore-roof-at (561).742.6355.
CRY: AS 41...]J ;31.1,iCtl .. :n T•'
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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