EFTA00287034.pdf

the following for "Cyclic Pressure and Large Missile Impact". For the HVHZ, systems must have either a Miami-Dade NOA or ElIC Approval marked "For ('.se in the Miami-Dade County Notice of Acceptance INOA) 201. 202 and 203. (Large Missile - 9 lb.) Florida Building Code Testing Application Standard (TAS) 201, 202 am! 203. (Large Missile 9 lb.) American Society for Testing and Materials (ASTM) E 1886 and ASTM E 1996. (Large Missile - 9 lb.) Southern Standards Technical Document (SSTD) 12. (Large Missile 9 lb.) For Skylights Only: ASTM E 1886/E 1996. (Large Missile - 4.5 lb.) For Garage Doors Only: ANSI/DASMA 115. (Large Missile 9 lb.) II. All exterior openings arc fully protected at a minimum with impact resistant coverings, impact resistant doors and/or impact resistant window units that are listed as windbome debris protection devices in the product approval system of the State of Florida or Miami-Dade County and meet the requirements of one of the following for "'Cyclic Pressure and Large Missile Impact": ASTM E 1886 and ASTM E 1996. (Large Missile - 4.5 lb.) SST() 12. (Large Missile 4 lb. to 8 lb.) ' For Skylights Only: ASTM E 1886/E 1996. (1.arge Missile - 2 to 4.5 lb.) C. All exterior openings are fully protected at a minimum with impact resistant coverings. impact resistant doors and/or impact resistant window units that are listed as windbome debris protection devices in the product approval system of the State of Florida or Miami-Dade County and meet the requirements of one of the following for "Cyclic Pressure and Small Missile Impact": Miami-Dade County NOA 201. 202 and 203. (Small Missile - ?grams) Florida Building Code TAs 201 202 and 203. (Small Missile 2 grams) ASTM E 1886 ggLASTM E 1996. (Small Missile 2 grams) SSTD 12. (Small Missile - 2 grams) O. All exterior openings arc fully protected with windbome debris protection devices that cannot be indentifred as Miami- 1)ade or Florida Building Code (FIX') product approved. This does not include plywood/OM; or plywood alternatives (see Answer "IV). All Glazed Exterior Openings E. All glazed exterior openings arc fully protected at a minimum with impact resistant coverings and/or impact resistant window units that meet the requirements of one of the standards listed in Answer "A" of this question. (Large Missile 9 lb.) F. All gland exterior openings are fully protected at a minimum with impact resistant coverings and/or impact resistant window units that meet the requirements of one of the standards listed in Answer "B" of this question. (Large Missile - 2 lb. - S lb ) G. All gland exterior openings are fully protected at a minimum with impact resistant coverings and/or impact resistant window units that meet the requirements of one of the standards listed in Answer "C" of this question. (Small Missile - 2 grams) II. All glazed exterior openings arc covered with plywood/OSB meeting the requirements of Section 1609 and Table 1609.1.4 of the 2004 FBC (with 2006 supplements). I. All glazed exterior openings are fully protected with wind-borne debris protection devices that cannot be identified as Miami-Dade or l'BC product approved. This does not include plywood/OSA or other plywood alternatives that do not meet Answer H (see Answer IC."). None or Some Glazed Openings X J. At least one glazed exterior opening does not have wind-borne debris protection. K. No glazed exterior openings have wind-borne debris protection. This includes plywood/OSB or plywood alternative systems that do not meet Answer "Fl". 1. L. Unknown or undetermined. Inspectors Initials PR Property Address *This verification form is valid up to five (5) years provided no material changes have been made to the structure. 01R-BI-1802 (Rev. 02/10) Adopted by Rule 690-170.0155 Page 3 of EFTA00287034 L. Other: F. unknown or unidentified. (i. \o attic access. 1 Roof to Wall Attachment: What is the weakest roof to wall connection? A. Toe Nails Rafter/truss anchored to top plate of wall using nails driven at an angle through the rallentruss and attached to the top plate of the wall. B. Clips Metal attachments on every rafier/truss that are nailed to one side (or both sides in the case of a diamond type clip) of the rafter/truss and attached to the top plate of the wall frame or embedded in the bond beam. X C. Single Wraps Metal Straps must he secured to every rafter/truss with a minimum of 3 nails, wrapping over and securing to the opposite side of the rafter/truss with a minimum of I nail. The Strap must be attached to the top plate of the wall frame or embedded in the bond beam in at least one place. D. Double Wraps Both Metal Straps must be secured to every rafter/truss with a minimum of 3 nails. wrapping over and securing to the opposite side of the raticr/truss with a minimum of I nail. Each Strap must be attached to the top plate of the wall frame or embedded in the bond beam in at least one place. F. Structural Anchor bolts structurally connected or reinforced concrete roof. F. Other: G. Unknown or Unidentified H. No attic access 5. Roof Geomelrv: What is the roof shapc(s)? (Porches or carports that arc attached only to the fascia or wall of the host structure and not structurally connected to the main roof system arc not considered in the roof geometry determination.) X A. Flip Roof Ilia roof with no other roof shapes greater than 10% of the total building perimeter. B. Non-Hip Roof Any other roof shape or combination of roof shapes including hip, gable. gambrel. mansard and other roof shapes not including Bat roofs. C. Flat Roof Flat roof shape greater than 100 square feet or 10% of the entire roof. whichever is greater. 6. Gable End Bracing: For roof structures that contain gables, please check the weakest that apply: ' A. Gable End(s) arc braced at a minimum in accordance with the 2001 Florida Building ('ode. B. Does not meet the above minimum requirements. X C. Not applicable. unknown or unidentified. 7. Nall Const ruction me: ('heck all wall construction types for exterior walls of the structure and percentages for each: )(' A. Wood Frame B. Un-Reinforced Masonry X C. Reinforced Masonry L D. Poured Concrete L. E. Other: 80 oa 8. Secondan Water Resistance (SW R1: (standard undedayments or hot mopped felts arc not SWR) A. SW R Self adhering polymer modified bitumen roofing underlayntem applied directly to the sheathing or foam adhesive SWR harrier (not foamed on insulation) applied as a secondary means to protect the dwelling from water intrusion. >1 B. No SWR C. Unknown or undetermined. 9. °genial Protection: What is the weakest form of wind borne debris protection installed on the structure? (Exterior openings include. but are not limited to: windows, doors, garage doors. skylights. etc. Product approval may be required for opening protection devices without proper rating identification.) A. All Exterior Orienines (Glazed and Unglazed) All exterior openings arc fully protected at a minimum with impact resistant coverings. impact resistant doors and/or impact resistant window units that arc listed as wind borne debris protection devices in the product approval system of the State of Florida or Miami-Dade Counts and meet the requirements of one of Inspectors Initials Property Address •This verification form is valid up to five (5) years provided no material changes have been made to the structure. OIR-BI-1802 (Rev. 02/10) Adopted by Rule 690.170.0155 Page 2 r?/"-I EFTA00287035 Uniform Mitigation Verification Inspection Form Maintain a cony of this form with the insurance policy Inspection Date: n u% 12 .2 O 11 Owner Information • (miler Name: a N ivkc. Contact Person: Addis : thane Phone: City: Work Phone: County ('ell Phone: Insunmee a: Year or Mime. "16 it or Stories: it Qt. (print name of the individual who actually performed the inspection), personally conducted the inspection of the residence identified on this form and in my professional opinion. all the data I reported is true and correct. I. Building Code: What building code was used to design and build the structure? A. 1994 South Florida Building ('ode (building permit application date of 9/1/1994 or later in Miami-Dade and Broward Counties (also known as the Iligh Velocity Hurricane Zone (11V117.1). S B. Building code prior to the 1994 South Florida Building Code (building permit application date of 8/31/1994 or earlier in Miami-Dade and Broward Counties (HVHZ). C. 2001 Florida Building Code (building penult application date of 311/2002 or later outside the D. Building code prior to the 2001 Florida Building Code (building permit application date of 2/28/2002 or earlier outside the F. Unknown or undetermined. 2. Predominant Roof Covering: Permit Application Date: Iiitt or Date of Installation: Of 0_3/4ms 40 404, 34. X A. At a minimum meets the 2001 Florida Building ('ode or the 1994 South Florida Building Code and has a Miami-Dadc NOA or FBC 2001 Product Approval listing demonstrating compliance with ASTM D 3161 (enhanced for 1 I0MPIHOR ASTM D 7158 (F. G or H), OR FBC TAS 100.95 and 'I'AS 107-95, OR FMRC 4470 and/or 4471 (for metal roofs). B. Does not meet the above minimum requirements. C. Unknown or undetermined. NOTE: At least one photo documenting the existence of each visible and accessible construction or mitigation attribute marked in Sections 3 through 9 must accompany this form. 3. Roof Deck Mtachment: What is the weakest form of roof deck attachment? A. I'I„vtxxf Oriented strand board (O513) roof sheathing attached to the roof truss/rafter (spaced a maximum of 24" o.c.) by staples or 6d nails spaced at 6" along the edge and 12" in the field. -OR- Batten decking supporting wood shakes or wood shingles.-OR- Any system of screws. nails, adhesives, other deck fastening system or truss/rafter spacing that has an equivalent mean uplift resistance of 55 psi. R. Ply wood'OSB roof sheathing with a minimum thickness of 7/16" attached to the roof truss/rafter (spaced a maximum of 24" o.c.) by 8d common nails spaced 6" along the edge and 12" in the field.-OR- Any system 01' screws, nails, adhesives. other deck fastening system or truss/rafter spacing that has an equivalent mean uplift resistance of 103 psf. ('. Plywood/OSB roof sheathing with a minimum thickness of 7/16" attached to the roof truss/rafter (spaced a maximum of 24" o.c.) by 8d common nails spaced 6" along the edge and 6" in the field. -OR- Dimensional lumber/longue & Groove decking with a minimum of 2 nails per board. -OR- Any system of screws, nails, adhesives, other deck fastening system or truss/rafter spacing that has an equivalent mean uplift resistance of 182 psf. D. Reinforced Concrete Roof Deck. Inspectors Initials pR Property Address_ *This verification form is valid up to live (5) years provided no material changes have been made to the structure. O1R-81-1802 (Rev. 02/10) Adopted by Rule 690-170.0155 /'age I (1 4 EFTA00287036 MITIGATION INSPECTIONS MUST BE CERTIFIED 814 QUALIFIED INSPECTOR. Section 627.711(2), Florida Statutes, provides a listing of individuals who may sign this form. Qualified Inspect Name: A I License Type: II it'd lc am SVO‘ Inspection Company. Peter Rims le-. lei C. Qualified Inspector — I hold an active license or certificate as a: (check one) Hurricane mitigation inspector certified by the My Safe Florida !Ionic Program. X Building code inspector certified under Section 468.607. Florida Statutes. i General, building or residential contractor licensed under Section 489.1 I I, Florida Statutes. Professional architect licensed under Section 481.213. Florida Statutes. ! Professional engineer licensed under Section 471.015. Florida Statutes. Other individual or entity recognized by the insurer as possessing the necessary qualifications to properly complete this font pursuant to Section 627.711(280. Florida Statutes. License N or Mtilrll wnilicate Individuals signing this form must have their license or certificate in an "Active" status at time of the inspection. I. alga, k IAS L am a qualified inspector and I personally performed the inspection or had (print nine) my employee ( ) perform the inspection and I agree to be responsible for his/her work. (prim name) Qualified Inspector Signature: Date: An individual or entity who knowingly provides or utters a false or fraudulent mitigation verification form with the intent to obtain or receive a discount on an insurance premium to which the individual or entity is not entitled commits a misdemeanor of the first degree (Section 627.711(3). Florida Statutes). The Qualified Inspector who certifies this form is strictly liable for all acts, statements, concealment of facts, omissions, and documentation provided by his or her employee who actually performed the inspection. Homeowner to complete: I certify that the named Qualified Inspector or his or her employee did perform an inspection of the residence identified on this form and that proof of identification was provided to me or my Authorized Representative. Signature: Date: An individual or entity who knowingly provides or utters a false or fraudulent mitigation verification form with the intent to obtain or receive a discount on an insurance premium to which the individual or entity is not entitled commits a misdemeanor of the first degree. (Section 627.711(3), Florida Statutes) The definitions on this form are for inspection purposes only and cannot be used to certify any product or construction feature as offering protection from hurricanes. Inspectors Initials PP Property Address r [his verification form is valid up to five (5) years provided no material changes have been made to the structure. O1R-B1-1802 (Rev. 02/10) Adopted by Rule 690-170.0155 /'age J of .1 EFTA00287037