DBPR HR-7020 Division of Hotels and Restaurants Certificate of Balcony Inspection
2015 November 10 61C-3.001, FAC Page 1 of 1
Complete and submit this form if your public lodging establishment is 3 or more stories in height. The inspector must have
the education and experience to be competent to perform the inspection. The operator is responsible for verifying the
competency of the inspector.
The term “balcony means a landing or porch that is accessible to or used by the public…” The balcony inspection must
include platforms, stairways, railings and railways, guardrails, balustrades, parapets, and areas enclosed by screening or
other non-permanent building material. (Section 509.2112, F.S. and Rule 61C-3.001(5)(a), F.A.C.)
For new or renewal inspections complete sections 1 and 2. For a change of owner attach a copy of previous operator’s
valid, date-stamped Certificate of Balcony Inspection and complete Section 3.
For New or Renewal Only
Section 1 Establishment Information
Owner Name
License Number
Mailing Address
City
State
Zip Code
Establishment Name (DBA)
Establishment Address
City
County
Zip Code
Telephone Number(s):
For New or Renewal Only
Section 2 Inspection
I hereby certify that any and all balconies, platforms, stairways, railings and railways on the above-described premises
were inspected on _________ by a person competent to conduct such inspection, and were found by such person to be
safe, secure and free of defects.
Total Number of Areas Inspected: Total Number of Defects Found: Date Repairs Completed:
The Inspection was conducted by _________ who is competent to conduct such inspections because: (Provide
facts/credentials establishing competency on the line below.)
Date
Name of Operator
Date
For Change of Owner Only
Section 3 Management Information
Name of Operator
Date
Signature of Operator
Note: This Certificate of Balcony Inspection expires three years from the date of inspection listed in Section 2 of
this form or from the date of inspection listed in Section 2 of the attached previous owner’s form. A new
Certificate of Balcony Inspection must be completed and submitted prior to the expiration date.
STATE OF FLORIDA, DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
Phone: 850.487.1395 Web: http://www.MyFloridaLicense.com/contactus/ & www.myfloridalicense.com/DBPR/hotels-
restaurants/