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Roofing Package PDF (City of Hialeah)

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ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
FLORIDA BUILDING CODE — BUILDING 15.31
SECTION 1525
HIGH-VELOCITY HURRICANE ZONES UNIFORM PERMIT APPLICATION
Florida Building Code Edition 2010
High-Velocity Hurricane Zone Uniform Permit Application Form.
INSTRUCTION PAGE
COMPLETE THE NECESSARY SECTIONS OF
THE UNIFORM ROOFING PERMIT
APPLICATION FORM AND ATTACH THE
REQUIRED DOCUMENTS AS NOTED BELOW:
Roof System
Required Sections of the
Permit Application Form
Attachments Required
See List Below
Low Slope Application A,B,C 1,2,3,4,5,6,7
Prescriptive BUR-RAS 150 A,B,C 4,5,6,7
Asphaltic Shingles A,B,D 1,2,4,5,6,7
Concrete or Clay Tile A,B,D,E 1,2,3,4,5,6,7
Metal Roofs A,B,D 1,2,3,4,5,6,7
Wood Shingles and Shakes A,B,D 1,2,4,5,6,7
Other As Applicable 1,2,3,4,5,6,7
ATTACHMENTS REQUIRED:
1. Fire Directory Listing Page
2. From Product Approval:
Front Page
Specific System Description
Specific System Limitations
General Limitations
Applicable Detail Drawings
3.
Design Calculations per Chapter 16, or If Applicable, RAS 127 or
RAS 128
4. Other Component of Product Approval
5. Municipal Permit Application
6. Owners Notification for Roofing Considerations (Reroofing Only)
7. Any Required Roof Testing/Calculation Documentation
15.32 FLORIDA BUILDING CODE — BUILDING
ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
Florida Building Code Edition 2010
High-Velocity Hurricane Zone Uniform Permit Application Form.
Section A (General Information)
Master Permit No.__________________________________ Process No. _________________________
Contractor’s Name ______________________________________________________________________
Job Address____________________________________________________________________________
ROOF CATEGORY
o Low Slope o Mechanically Fastened Tile o Mortar/Adhesive Set Tile
o Asphaltic
Shingles
o Metal Panel/Shingles o Wood Shingles/Shakes
o Prescriptive BUR-RAS 150
ROOF TYPE
o New Roof o Reroofing o Recovering o Repair o Maintenance
ROOF SYSTEM
INFORMATION
Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) Total (SF)
Section B (Roof Plan)
Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains.
Include dimensions of sections and levels, clearly identify dimensions of elevated pressure zones and location of
parapets.
Section C (Low Slope Application)
Fill in specific roof assembly components
and identify manufacturer
(If a component is not used, identify as “NA”)
System Manufacturer:______________________________
Product Approval No.:______________________________
Design Wind Pressures, From RAS 128 or Calculations:
Pmax1:________ Pmax2:_________ Pmax3:_________
Max. Design Pressure, from the specific Product
Approval system:_________________________________
Deck:
Type:_______________________________________
Gauge/Thickness:_____________________________
Slope:______________________________________
Anchor/Base Sheet & No. of Ply(s):___________________
Anchor/Base Sheet Fastener/Bonding Material:
_______________________________________________
Insulation Base Layer: _____________________________
Base Insulation Size and Thickness: _________________
Base Insulation Fastener/Bonding Material:
________________________________________________
Top Insulation Layer: ______________________________
Top Insulation Size and Thickness: __________________
Top Insulation Fastener/Bonding Material:
________________________________________________
Base Sheet(s) & No. of Ply(s): ___________________
Base Sheet Fastener/Bonding Material:
________________________________________________
Ply Sheet(s) & No. of Ply(s): _____________________
Ply Sheet Fastener/Bonding Material:
________________________________________________
Top Ply: _________________________________________
Top Ply Fastener/Bonding Material:
_____________________________________________
Surfacing: _____________________________________
Fastener Spacing for Anchor/Base Sheet Attachment:
Field: ____” oc @ Lap, # Rows ____ @ ____” oc
Perimeter: ____” oc @ Lap, # Rows ___ @ ____” oc
Corner: ____” oc @ Lap, # Rows ____ @ ____” oc
Number of Fasteners Per Insulation Board:
Field _____ Perimeter _____ Corner _____
Illustrate Components Noted and Details as
Applicable:
Woodblocking, Gutter, Edge Termination, Stripping, Flashing,
Continuous Cleat, Cant Strip, Base Flashing, Counter-
Flashing, Coping, Etc.
Indicate: Mean Roof Height, Parapet Height, Height of Base
Flashing, Component Material, Material Thickness, Fastener
Type, Fastener Spacing or Submit
FLORIDA BUILDING CODE — BUILDING 15.33
ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
Florida Building Code Edition 2010
High-Velocity Hurricane Zone Uniform Permit Application Form.
Parapet
Height
Mean
Roof
Height
FT.
FT.
15.34 FLORIDA BUILDING CODE — BUILDING
ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
Florida Building Code Edition 2010
High-Velocity Hurricane Zone Uniform Permit Application Form.
Section D (Steep Sloped Roof System)
Roof System Manufacturer:
___________________________________________
Notice of Acceptance Number:
________________________________________
Minimum Design Wind Pressures, If Applicable (From RAS 127 or
Calculations):
P1: ____________ P2: ___________ P3: ___________
Maximum Design Pressure
(From the Product Approval Specific System):
____________________________
Roof Slope:
_______: 12
Ridge Ventilation?
___________________
Mean Roof Height: ___________
Type Underlayment:
Deck Type:
Insulation:
Fire Barrier:
Fastener Type & Spacing:
Adhesive Type:
Type Cap Sheet:
Roof Covering:
Type & Size Drip
Edge:
Steep Sloped Roof System Description
FLORIDA BUILDING CODE — BUILDING 15.35
ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
Florida Building Code Edition 2010
High-Velocity Hurricane Zone Uniform Permit Application Form.
Section E (Tile Calculations)
For Moment based tile systems, choose either Method 1 or 2. Compare the values for M
r
with the values from M
f
. If the M
f
values are greater than or
equal to the M
r
values, for each area of the roof, then the tile attachment method is acceptable.
Method 1 “Moment Based Tile Calculations Per RAS 127”
(P
1
: _______ ×λ_______ =_______ ) - Mg: _______ = M
r1
_______ Product Approval M
f
_______
(P
2
: _______ ×λ _______ =_______ ) - Mg: _______ = M
r2
_______ Product Approval M
f
_______
(P
3
: _______ ×λ _______ =_______ ) - Mg: _______ = M
r3
_______ Product Approval M
f
_______
Method 2 “Simplified Tile Calculations Per Table Below”
Required Moment of Resistance (Mr) From Table Below _______ Product Approval M
f
_______
M
r
required Moment Resistance*
Mean Roof Height ®
Roof Slope ¯
15’ 20’ 25’ 30’ 40’
2:12 34.4 36.5 38.2 39.7 42.2
3:12 32.2 34.4 36.0 37.4 39.8
4:12 30.4 32.2 33.8 35.1 37.3
5:12 28.4 30.1 31.6 32.8 34.9
6:12 26.4 28.0 29.4 30.5 32.4
7:12 24.4 25.9 27.1 28.2 30.0
*Must be used in conjunction with a list of moment based tile systems endorsed by the Broward County Board of Rules and Appeals.
For Uplift based tile systems use Method 3. Compared the values for F’with the values for Fr. If the F’values are greater than or equal to the Fr values,
for each area of the roof, then the tile attachment method is acceptable.
Method 3 “Moment Based Tile Calculations Per RAS 127”
(P
1
: ______ × L ______ =______ × w: = ______) - W: ______ × cos q ______ =F
r1
______ Product Approval F′ ______
(P
2
: ______ × L ______ =______ × w: = ______) - W: ______ × cos q ______ = F
r2
______ Product Approval F′ ______
(P
3
: ______ × L ______ =______ × w: = ______) - W: ______ × cos q ______ = F
r3
______ Product Approval F′ ______
Where to Obtain Information
Description Symbol Where to find
Design Pressure P1 or P2 or P3 RAS 127 Table 1 or by an engineering analysis prepared by PE based on ASCE 7
Mean Roof Height H Job Site
Roof Slope q Job Site
Aerodynamic Multiplier l Product Approval
Restoring Moment due to
Gravity
M
g
Product Approval
Attachment Resistance M
f
Product Approval
Required Moment Resistance M
g
Calculated
Minimum Attachment
Resistance
F′ Product Approval
Required Uplift Resistance Fr Calculated
Average Tile Weight W Product Approval
Tile Dimensions
L = length
W = width
Product Approval
All calculations must be submitted to the building official at the time of permit application.
City of Hialeah
ROOFING PERMIT FEE-SHEET
High Velocity Hurricane Zone
Permit # ___________ Job Address: _____________________________ Contractor: _________________
Please enter the square footage for the roofing work you are performing in the space provided next to the
appropriate roof type for your job. Listed below each roof type are the minimum required inspections. If your
roof type does not fit in the specific categories listed, please see a building processor or inspector. All roofing
systems must be installed as per the Florida Building Code, Manufactures Specification, Product Control
Approvals and Protocols. Minimum roofing permit fee is $180.00.
Building Use: Single Family/Duplex (R3) Multi-Family (#Units ______ )(R2) Commercial (Other)
Application for Roof Type
New Roof Re-Roof Repair Recovery Maintenance*
Repair required inspections: 1. In Progress
2. Final
CATEGORY 92- LOW SLOPE APPLICATIONS (Gravel, Smooth, Modified, Single Ply EPDM, SPRM)
Fee Code
Description
Fee Calculation
Unit
Fee
RF01 Roofing (Groups R2 & R3)
0.15 per sq. ft. of roof coverage Sq. Ft. _________ ________________
RF02
RF03
Roofing (Other Groups)
0.15 per sq. ft. for first 30,000 sq. ft.
0.10 per sq. ft. thereafter
Sq. Ft.
________________
REQUIRED INSPECTIONS
1. Before anchor sheet is covered** **-Always check with inspector for additional inspections.
2. Final
CATEGORY 93- TILE ROOF (Nail-on Application)
Fee Code
Description
Fee Calculation
Unit
Fee
RF01A Roofing (Groups R2 & R3)
0.20 per sq. ft. of roof coverage Sq. Ft. _________ ________________
RF02A
RF03A
Roofing (Other Groups)
0.20 per sq. ft. for first 30,000 sq. ft.
0.10 per sq. ft. thereafter
Sq. Ft.
________________
REQUIRED INSPECTIONS
1. Tin Cap
2. In-progress
3. Tile Installation
4. Final
Under penalties of perjury, I declare that to the best of my knowledge, the facts stated in this document are true. I understand that
perjury is a felony of the third degree.
________________________________ (L.S.)
Signature
Page 1 of 2 7.2014
*- Maintenance is charged by minimum permit fee or per valuation according to Building Department fee schedule as determined by
processor.
CATEGORY 94- TILE ROOF (Mortar/Adhesive Set Application)
Fee Code
Description
Fee Calculation
Unit
Fee
RF01A Roofing (Groups R2 & R3)
0.20 per sq. ft. of roof coverage Sq. Ft. _________ ________________
RF02A
RF03A
Roofing (Other Groups)
0.20 per sq. ft. for first 30,000 sq. ft.
0.10 per sq. ft. thereafter
Sq. Ft.
________________
REQUIRED INSPECTIONS
1. Tin Cap
2. In-progress
3. Tile Installation
4. Final
CATEGORY 95-SHINGLES (Asphalt, Fiberglass, SBS)
Fee Code
Description
Fee Calculation
Unit
Fee
RF01 Roofing (Groups R2 & R3)
0.15 per sq. ft. of roof coverage Sq. Ft. _________ ________________
RF02
RF03
Roofing (Other Groups)
0.15 per sq. ft. for first 30,000 sq. ft.
0.10 per sq. ft. thereafter
Sq. Ft.
________________
REQUIRED INSPECTIONS
1. Tin Cap
2. Shingle in Progress
3. Final
CATEGORY 96- METAL ROOF (Standing Seams, Panels, Tiles, Etc.)
Fee Code
Description
Fee Calculation
Unit
Fee
RF01A Roofing (Groups R2 & R3)
0.20 per sq. ft. of roof coverage Sq. Ft. _________ ________________
RF02A
RF03A
Roofing (Other Groups)
0.20 per sq. ft. for first 30,000 sq. ft.
0.10 per sq. ft. thereafter
Sq. Ft.
________________
REQUIRED INSPECTIONS Total Fee: $ ___________
1. Tin Cap
2. Fire Barrier
3. In Progress
4. Final
WARNING
A) C
hapter 455 of the Florida Statutes provides for fines in the amount of $500.00 to $5000.00 for any consumer (owner-builder,
contractor, etc.), who “aids and abets the unlicensed practice of a professional by employing such unlicensed person.”
B) A
Product Control “Notice of Acceptance” and method of installation must be provided at time of permit application and
posted at job site for inspection on all roofing system.
C) The Contractor or owner-
builder must provide an O.S.H.A. APPROVED ladder for roof access at the time of inspection.
Failure to do so will result in reinspection fee.
Page 2 of 2 7.2014
City of Hialeah
Building Department
OWNERS AFFIDAVIT OF EXEMPTION
ROOF-TO-WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EXISTING SITE-BUILT
SINGLE
FAMILY RESIDENTIAL STRUCTURES PURSUANT TO SECTION 553.844 F.S.
To: City of Hialeah
Building Official
501 Palm Avenue
Hialeah, Florida
Re: Owners Name
Property Address
Roofing Permit Number
Dear Building Official:
I, ____________________________ certify that I am not required to retrofit the roof-to-wall connections of
my building because:
□ The just valuation for the structure for purposes of ad valorem taxation is less than $300,00.00
□ The building was constructed in compliance with the provisions of the Florida Building Code (FBC) or
with the provisions of the 1994 edition of the South Florida Building Code (1994 SFBC)
___________________________ ___________________________
Signature of Property Owner Print Name
State of Florida County of Miami-Dade
Sworn to and subscribed before me this _____ day of ________________________________.
□ Personally Known □ Produced Identification ________________________________
Notary Signature ________________________
Seal
When the just valuation of the structure of ad valorem taxation is equal to or more than $300,00.00, and the
building was not constructed in compliance with the FBC nor with 1994 SFBC, an affidavit of Roof-to-Wall
Connection Mitigation Retrofit must be provided.
Building Dep a rtmen t 501 Palm Avenue, Second Floor, Hia lea h, FL 33010 Offic e
305.883.5825 www.hia leahf l.gov
Rev
. 10.9.14
City of Hialeah
Building Department
AFFIDAVIT OF COMPLIANCE
ROOF-TO-WALL CONNECTION
HURRICANE MITIGATION RETROFIT FOR EXISTING SITE-BUILT SINGLE
FAMILY RESIDENTIAL STRUCTURES PURSUANT TO SECTION 553.844 F.S.
To: City of Hialeah
Building Official
501 Palm Avenue, 2
nd
Floor
Hialeah, Florida 33010
Re: Owners
Name
Property Address
Roofing Permit Number
Dear Building Official:
I _____________________________
____, certify that I have improved the roof-to-wall connections of the
referenced property as required by the “Manual of Hurricane Mitigation Retrofits for Existing Site-Built Single
Family Residential Structures” as adopted by the Florida Building Commission by Rule 9B-3.047 F.A.C
_____________________________ _____________________________
Signature of Qualifying Agent Print Name
State of Florida County of Miami-Dade
Sworn to and subscribed before me this _____ day of __________________________________.
□ Personally Known □ Produced Identification ____________________________________
Notary
Signature ____________________________ Seal
Building Department 501 Palm Avenue, 2
nd
Floor, Hialeah, FL 33010 Office 305.883.5825
www.hialeahfl.gov
Rev. 10.9.14
Section 1524
High Velocity Hurricane Zones-Required Owners Notification for Roofing Considerations
1524.1 Scope. As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with the
required roofing permit, and to explain to the owner the content of this section. The provisions of Chapter 15 of the
Florida Building Code, Building govern the minimum requirements and standards of the industry for roofing system
installations. Additionally, the following items should be addressed as part of the agreement between the owner and the
contractor. The owner’s initial in the designated space indicates that the item has been explained.
1. Aesthetics-workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane Zone)
are for the purpose of providing that the roofing system meets the wind resistance and water intrusion
performance standards. Aesthetics (appearance) are not a consideration with respect to workmanship
provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code,
should be addressed as part of the agreement between the owner and the contractor.
2. Renailing wood decks: When replacing roofing, the existing wood roof deck may have to be renailed in
accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida
Building Code. (The roof deck is usually concealed prior to removing the existing roof system).
3. Common roofs: Common roofs are those which have no visible delineation between neighboring units
(i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or
owner should notify the occupants of adjacent units of roofing work to be performed.
4. Exposed ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be
viewed from below. The owner may wish to maintain the architectural appearance; therefore, roofing
nail penetrations of the underside of the decking may not be acceptable. The owner provides the option
of maintaining this appearance.
5. Ponding water: The current roof system and/or deck of the building may not drain well and may cause
water to pond (accumulate) in low-lying areas of the roof. Ponding can be an indication of structural
distress and may require the review of a professional structural engineer. Ponding may shorten the life
expectancy and performance of the new roofing system. Ponding conditions may not be evident until the
original roofing system is removed. Ponding conditions should be corrected.
6. Overflow scuppers (wall outlets): It is required that rainwater flow off so that the roof is not
overloaded from a buildup of water. Perimeter/edge walls or other roof extensions may block this
discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow
scuppers in accordance with the requirements of: Chapter 15 and 16 herein and the Florida Building
Code, Plumbing.
7. Ventilation: Most roof structures should have some ability to vent natural airflow through the interior of
the structural assembly (the building itself). The existing amount of attic ventilation shall not be reduced.
Exemption: Attic spaces, designed by a Florida-licensed engineer or registered architect to eliminate the
attic venting, venting shall not be required.
Property Address: __________________________________ _ Permit No.: __________________
Owner’s/Agent’s Signature: ___________________________________ Date: __________________
Contractor’s Signature: __________________________________ __ Date: __________________
Revised 1.26.15
City of Hialeah
Building Department
SHEATHING AFFIDAVIT
Certificate of Compliance
Job Address: Permit No.:
Name of Roofing Company:
Name of Qualifier: License No.:
Address:
I, , do hereby affirm:
(Print Name of Qualifier)
That
I have personally inspected the re-nailing of the existing roof sheathing as required by the Florida Building
Code 2010 (FBC) Section 2322.2.8 for the area covered by the roofing permit referenced above and further state
that the re-nailing of the sheathing meets the requirements of the current edition of the Florida Building Code
Section 2322.2.
FBC Section 2322.2.2, board roof sheathing shall have a net thickness of not less than 3/4 inch when the span is
not more than 28 inches or 5/8 inch when the span is not more than 24 inches, shall have staggered joints and
shall be nailed with 8d common nails not less than two in each 6 inch board nor three in each 8 inch board at
each support.
FBC S
ection 2322.2.8, When existing roofs are re-roofed to the point that the existing roofing is removed down
to the sheathing, the existing roof sheathing shall be re-nailed with 8d common nails (0.131 diameter by 2 ½”
long with a 0.281 diameter full round head). Power driven 8d nails shall be of the same dimensions. Nail
spacing shall be six inches on center at panel edges, six inches on center at intermediate supports and where
applicable 4 inches on center over gable ends and sub-fascia. Existing fasteners may be used to achieve such
minimum spacing.
Qualifier’s Signature Date
, having first been duly sworn, does affirm the above statement
(Print Name of Qualifier) to be true and correct by his own personal knowledge.
Notary Signature (Seal/Stamp) Date
Personally known to me Produced photo ID Type of ID
City of Hia leah - Building D ivision 501 Palm Avenu e, 2
nd
Floor, Hia leah, FL 33010 Of fice 305.883.5825
www.hia leahf l.gov
City of Hialeah
Building Department
ROOFING AFFIDAVIT
Certificate of Compliance
Job Address: Permit No.:
Name of Roofing Company:
Name of Qualifier: License No.:
Address:
I hereby certify to the City of Hialeah, Building Department that all portions of the above described roof
improvements, covered and unseen by the Roofing Inspector during “in-progress” inspections, was constructed
and/or installed in accordance with approved plans, specifications and Product Control Approval as per Florida
Building Code.
Qualifier’s Signature Date:
, having first been duly sworn, does affirm the above statement
(Print Name of Qualifier) to be true and correct by his own personal knowledge.
Notary Signature (Seal/Stamp) Date
Personally known to me Produced photo ID Type of ID
City of Hialeah - Building Department 501 Palm Avenue, 2
nd
Floor, Hialeah, FL 33010 Office 305.883.5825
www.hialeahfl.gov
INSTRUCTION
S FOR COMPLETING AND RECORDING A
NOTICE OF COMMENCEMENT
Completion of Form:
All information must be typewritten or legibly printed.
All applicable line numbers must be completed. Items 1, 2, and 3 are always to be filled in. Items 4
through 9 are to be completed as applicable. For lengthy descriptions, attach a separate page and
indicate on the form that the legal description is attached. Should line 5 apply, a photocopy of the
Payment Bond must be attached to the instrument when recorded.
The property owner or owner’s authorized agent must sign in the presence of a Notary Public, who
must then complete the acknowledgement portion of the form and affix notary public’s seal. The
Miami-Dade County Recorder’s Office does not have notaries that may provide this service. This
portion needs to be completed before hand.
Recording Information:
Prepare a self-addressed, stamped envelope with the name and address of whom the recorded
notice is to be returned.
Count the total number of pages in the document. Fees are $10.00 for the first page and $8.50 for
subsequent pages.
Your document takes about four to six weeks to process and return, should you need it any sooner
you may walk it in and take a certified copy that same day.
Payments are accepted in the form of Cash, Certified or Cashier’s Check, or Money Order made
payable to the Clerk of Courts. MasterCard and Visa are accepted subject to a $15.00 minimum.
Walk in Address: Miami-Dade County Recorder Office
22 NW 1 Street
Miami, Florida 33128
Hours of Operation: 9:00 a.m. – 4:00 p.m.
Telephone: (305) 275-1155
Press 1 for English, 2 for Spanish, then;
Press 6 for Recorder Office, then;
Press 1 for Documents, then;
Press 0 for Operator
Mailing Address: Miami-Dade County Recorder Office
P.O. Box 011711
Flagler Station
Miami, Florida 33101
Notice of Commencement
Page 1 of 2
www.hialeahfl.gov
Turn Over for Instructions www.hialeahfl.gov
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. _______________________ TAX FOLIO NO. _______________________
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
THE UNDERSIGNED hereby gives notice that improvement will be made to
certain real property, and in accordance with Chapter 713, Florida Statutes,
the following information is provided in this Notice of Commencement.
1. Legal description of property and street address: ____________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
2. General description of improvement:_____________________________________________________________________________
__________________________________________________________________________________________________________
3. Owner(s) name and address:___________________________________________________________________________________
__________________________________________________________________________________________________________
Interest in property:___________________________________________________________________________________________
Name and address of fee simple titleholder (if other than owner):__________________________________________________________
__________________________________________________________________________________________________________
4. Contractor’s name, address, and phone number:_____________________________________________________________________
__________________________________________________________________________________________________________
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address:____________________________________________________________________________________________
Amount of bond: $____________________________________________________________________________________________
6. Lender’s name, address, and phone number:________________________________________________________________________
__________________________________________________________________________________________________________
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section
713.13(1)(a)7., Florida Statutes:
Name, address, and phone number:________________________________________________________________________________
__________________________________________________________________________________________________________
8. In addition to himself or herself, Owner designates the following person(s) to receive a copy of the Lienor’s Notice as provided in Section
713.13(1)(b), Florida Statutes:
Name, address, and phone number:________________________________________________________________________________
__________________________________________________________________________________________________________
9. Expiration date of the Notice of Commencement (the expiration date is 1 year from the date of recording unless a different date is
specified):___________________________________________________________________________________________________
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13,
FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A
NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
______________________________________________
Signatory’s Title/Office
_________________________________________________________
Signature of Owner or Owner’s Authorized Officer/Director/Partner/Manager
_________________________________________________
Print Name
The foregoing instrument was acknowledged before me this __________ day of ____________________, 20____, by ________________
_____________________________ as ______________________________ (type of authority, e.g. officer, trustee, attorney in fact) for
____________________________________________________________ (name of party on behalf of whom instrument was executed).
Personally Known OR Produced Identification Type of Identification Produced: ____________________________________
_________________________________________________
Signature of Notary Public – State of Florida
Print, Type, or Stamp
Commissioned Name
of Notary Public: ______________________________
VERIFICATION PURSUANT TO SECTION 92.525, FLORIDA STATUTES.
Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief.
________________________________________________
Signature of Natural Person Signing Above
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Roofing Package PDF (City of Hialeah)

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Completed 15 July 2020

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