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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. 1a 0060 2(02- \
From: �,O�T()k1 �11�0 WC - 1 �Nvoicvc ict (Contractor)q
135. I\A . %t Its , ' \ , �,\\'�� Lan ' !h ntractor's Address)
WE.MV'j p1-,�Y.Q 1� 21 f (Owner/s Name)
151 C0 $1 V'Ttl �\1f:r o BCtl,k 5J'1Z.h (Property Address)
CERTIFICATION SELECTION: (Please check all that apply)
Certification of roof metal installation, flashing, underlayment.
Certification of re-nailiag roof sheathing,anddlremo1fval�,,)and replacement of damaged or rotted wood.
Other ME g -EZ. , IIICY 1N oc -
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I, Usk./ ' ort fiN 1 - , am certified as a roofing contractor (License No.
C«01 I D 43 ) 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 B-ach offers progressive
re-rro. inspections. I have notified the owner of the property of this affidavit.
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`�.nature oT4ualifier Da
/STATE OF FLORIDA, COUNTY OF PALM BEACH ,7`
The fo -..'.. ' strument was acknowledged before me this 3D (date)by',k w hi oar(q/ , who
is personally kr•wn o me or who has produced M 6 of t '2-7,07-0 (type of identification)as identification
• •• o did(did not)take an oath. D.1. ,,,,
Signature of person taking acknowledgement 445 ,. FRANK MILOHNICH
1
Name of officer taking acknowledgement—typed, printed or stampedommiIg'' Com omminsei•oFFn 066res
Eaplree
Title or rank Serial number February 04, 2018
100 East Boynton Beach Blvd,PO Box 310, Boynton Beach FL 33425-0310 Phone:(561)742-6350 Fax:(561)7424357
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7/12)
City of Boynton Beach
.0011j- Building Division
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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 tole-roof at;,(561) 742-6355.
100 East Boynton Beach Blvd,PO Box 310,Boynton Beach FL 33425-0310 Phone:(561)742-6350 Fax:(561)742-6357
S:IDevelopmentlBuilding\Forms&Templates1RooMgMelalBSheelhinglnstallationPolicy&AKdavit-1&2 family(12/02,1/03,12/03,11/05,9/06,03/09)
# 17- a05a-
FLO A ENGINEERING & TESTING, INC.
Phone: (866) 781-6889 •Fax: (866) 784-8550
www.floridaengineeringandtesting.com
250 S.W. 13th Avenue
Pompano Beach,FL 33069
August 30,2017 Job Order No.: 17-2912
Permit No.: 1700002652
Host Building
11 South Swinton Avenue
Delray Beach, Florida 33444
RE: TAS-106 TILE UPLIFT TESTS
Proposed Roof
Lax Residence
1510 S.W. 8th Avenue
Boynton Beach, Florida
Dear Sir or Madam:
In accordance with your authorization, Florida Engineering & Testing Inc., has performed
Tile Uplift Testing in compliance with Testing Application Standards TAS-106 and the
Florida Building Code High Velocity Hurricane Zone on August 29, 2017, at the above
referenced project.
The purpose of our inspection was to determine the uplift capacity of the roof tiles for the
residence at the above referenced project. The subject roof consisted of concrete flat tile
foam set. The pitch of the subject roof is 4/12.
Our field engineer's representative visited the site and conducted thirty-six (36) uplift
tests on the roof tiles. All tests were performed according to the Florida Building Code
High Velocity Hurricane Zone and protocol TAS-106 using an Intercomp scale model
CS200. The following is a summary of results:
Field Test Results
Test Number Test Location Field Uplift Pull Test Test Result
1 - 4 Corner See Attached Diagram 35 th 5 pounds Passed
5 - 22 Perimeter See Attached Diagram 35 t 5 pounds Passed
23 - 33 Field See Attached Diagram 35 f 5 pounds Passed
34 - 36 Ridge & Hip See Attached Diagram 35 ± 5 pounds Passed
Quality
PIA ?'j
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Page 2
August 30,2017 Job Order No. 17-2912 F LOtoA
Host Building
Lax Residence
1510 S.W.8th Avenue
Boynton Beach,Florida:
All test results were found to be in compliance with TAS-106 and the Florida Building
Code (see attached field sketch).
The test results are limited to the tested areas. If other roof areas exhibit different
conditions, it should be brought to our attention for remedial work. This uplift test is not
a fmal roof inspection. A final roof inspection must be conducted by the building official
for approval.
The test results presented reflect the condition of the roof system at the time of the test.
These results are time and sample dependent since roof conditions are continuously
changing due to exposure to the elements.
Florida Engineering & Testing, Inc. (FE&T) is an independent third party providing un-
biased testing information and results. FE&T is not affiliated with our client nor do we
have any financial interest in the project or determination of the test results.
As mutual protection to clients, the public and ourselves, all reports are submitted as the
confidential property of clients, and authorization for publication of statements,
conclusions or extracts from or regarding our reports is reserved pending our written
approval.
Florida Engineering & Testing, Inc., appreciates the opportunity to be of service to you at
this phase of your project. If you have any questions or comments, please give us a call.
We would be pleased to help in any way we can. It has been a pleasure working with you
and look forward to doing so again in the near future.
Sincerely,
��,00i11///i�"/
No.48202 \:0
Mark A. IvBiwutip, P.E. *
Florida Engine's/king �r,.k.it g, h
Florida Reg )48202
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