Genesis Home Inspections LLC
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1 Genesis Home Inspections LLC _ This Inspection was performed and Completed by a Licensed Home Inspector under Section , Florida Statutes who has completed the statutory number of hours of Hurricane Mitigation, 4-Point, and Roof Certification Inspection Training approved by the Construction Industry Licensing Board and completion of a proficiency exam; OR by a Certified General Contractor Licensed under Section , Florida Statutes. Any one or more of the following reports may be contained within: Uniform Mitigation Verification Inspection Form OIR-B (Rev. 01/12) 4 Point Inspection Report Citizens Roof Condition Certification Form (CIT RCF ) Supporting Digital Images Opening Protection Deficiency Notes Office (954) * ginspections@yahoo.com Notice to Policyholders: Inquires about insurance coverage and premiums should be directed to your insurance carrier. Limitations of Liability: Genesis Home Inspections LLC, performs observational inspections following InterNachi s stardards of practice, and we abide by a strict Code of Ethics. Genesis Home Inspections LLC s liability is expressly limited to the inspection fee paid.
2 R2503 Roof Condition Certification Form APPLICANT/INSURED NAME: APPLICATION/POLICY SANDRA HENRY #: ADDRESS INSPECTED: 1331 NW 50 AVENUE, FT. LAUDERDALE - FL DATE OF INSPECTION: This Roof Condition Certification Form must be inspected and completed by a verifiable Florida-licensed professional. Without an appropriately licensed inspector s dated signature, the form will not be accepted. The following FLORIDA-LICENSED individuals may complete this form for Citizens: A general, residential, building, or roofing contractor A building code inspector A registered architect A professional engineer A building code official who is authorized by the State of Florida to verify building code compliance A Florida-licensed home inspector NOTE: This form does not verify loss mitigation features. Use Uniform Mitigation Verification Inspection Form OIR-B ROOF (TWO PHOTOS OF THE ROOF S CONDITION ARE REQUIRED TO BE SUBMITTED WITH THIS FORM) Predominant Roof Covering Material: Roof Age (years): Remaining Useful Life: Date of Last Roofing Permit: Date of Last Update: If updated (check one): Full Replacement Partial Replacement % of Replacement Overall Condition of Roof: Excellent Good Fair Poor (explain) Asphalt Shingle 20 Years +/- 5 Years +/- None found /- Secondary Roof Covering Material: Roof Age (years): Remaining Useful Life: Date of Last Roofing Permit: Date of Last Update: N/A If updated (check one): Full Replacement Partial Replacement 100% % of Replacement Overall Condition of Roof: Excellent Good Fair Poor (explain) Any visible signs of damage / deterioration? (describe) (e.g. curling/ lifted/ loose/ missing shingles or tiles, sagging or uneven roof deck) Predominant Roof Secondary Roof Any visible signs of leaks? Predominant Roof Secondary Roof Additional Comments: 6 +/- damaged asphalt shingles. Unable to locate permit. Est. age given. Signs of completed repairs done in /-. CIT RCF A LL R OOF C ONDITION C ERTIFICATION I NSPECTIONS MUST BE INSPECTED, SIGNED AND COMPLETED BY A VERIFIABLE F LORIDA-LICENSED I NSPECTOR. I CERTIFY THAT THE ABOVE STATEMENTS ARE TRUE AND CORRECT. Inspector Name (printed) Telephone Number FABIAN WOJCICCHON (954) Home Inspector HI Signature of Inspector License Type License Number Date
3 1331 NW 50 AVENUE, FT. LAUDERDALE - FL ADDRESS VERIFICATION FRONT VIEW LEFT VIEW RIGHT VIEW LEFT VIEW RIGHT VIEW
4 1331 NW 50 AVENUE, FT. LAUDERDALE - FL REAR VIEW REAR VIEW ASPHALT SHINGLE ASPHALT SHINGLE SIGNS OF COMPLETED REPAIRS DONE IN /- SIGNS OF COMPLETED REPAIRS DONE IN /-
5 1331 NW 50 AVENUE, FT. LAUDERDALE - FL SIGNS OF COMPLETED REPAIRS DONE IN /- SIGNS OF COMPLETED REPAIRS DONE IN /- 6 +/- DAMAGED ASPHALT SHINGLES 6 +/- DAMAGED ASPHALT SHINGLES 6 +/- DAMAGED ASPHALT SHINGLES 6 +/- DAMAGED ASPHALT SHINGLES
6 1331 NW 50 AVENUE, FT. LAUDERDALE - FL /- DAMAGED ASPHALT SHINGLES ASPHALT SHINGLE CEILING NO SIGNS OF ACTIVE LEAKS CEILING NO SIGNS OF ACTIVE LEAKS PLYWOOD SHEATHING NO SIGNS OF ACTIVE LEAKS PLYWOOD SHEATHING NO SIGNS OF ACTIVE LEAKS
7 This Inspection was performed by a Licensed Home Inspector under Section , Florida Statutes who has completed the statutory number of hours of Hurricane Mitigation, 4-Point, and Roof Certification Inspection training approved by the Construction Industry Licensing Board and completion of a proficiency exam. (NACHI ) NACHI HOME INSPECTOR LICENSE WIND MITIGATION CERTIFICATE (OIR-B Rev.01/12) WIND MIT., 4-POINT, ROOF CERT., INSPECTION CERTIFICATE
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