PERMIT DOCUMENTS L,-r O` •
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tit City of Boynton Beach
°N ° 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. 1-70 000 z2-11 , . IInn 9 goo t—IWG
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From: (' C
'f ' O)pf7l ��0 --- - I'G� . ._. (Contractor)
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A-nun ( fit Ilti (Owner/s Name)
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ia RTIFICATION SELECTION: (Please check all that apply) Co n�FIRJ4 r s
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14ddr�SS
Certification of roof metal installation, flashing, underlayment.
AC rtification-JO
re-nailing roof sheathing, and removal andel replac �ennttyof damaged or rotted wood.
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Other � .16 I /11 Coe ( 0,7 ,COPT J Alio
I, CO Gl a ,Oe_ 1Q am certified as a roofing contractor (License No.
CCC 13? ) I OV ) 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
amended, and Manufacturer's Specifications. I understand that the City of Boynton Beach offers progressive
re-roof ins•s , •- - . , ' -• • - owner of the property of this affidavit. 6 In
Sign•e<c alifier ir Date
STATE OF FLORIDA, COUNTY OF PALM BEACH �j
The foregoing instrument was acknowledged before me thisD (date)by Mil Gc t tict'fcO ,who
is personally known to me or who has produced Vii/1 t I Il)t(S C Q Ul�type of e itc 44s identification
and who did(did not)take an oath. ,J6�.PHH..^^^•—•.V � ,
Signature of person taking acknowledgement .,.....:11,40
:NI NO7Agr''<�)
Name of officer taking acknowledgement—typed, printed or stampe• • A ._A A, Zt ve-•1>.., 1 Z
Title or rank llJ
to ,/ Pc'k71' ' Serial number S.(12.6f. 1900
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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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° A City of Boynton Beach
�`�� Building Division
Tp e
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'Firiatiis,the only scheduled inspection and an affidavit is supplied, the Inspector shall
add,the`gommen�t;•a;CERTIFIED," and pass the inspection.
�.;' J;7' .,ps
Piogressive•:re-rooHnspections may still be requested by calling the inspection clerk 24
hours,prior_fo;re-roof at (561) 742-6355.
n( ' 0
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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