Medley, FL · Miami-Dade County
Fire-Rated Joint and Penetration Affidavit
Affidavit certifying that fire-rated penetrations and joints in walls, floors, and ceilings meet Florida Building Code standards and ASTM/UL testing requirements.
What this form is
This affidavit documents that all penetrations through fire-resistance rated barriers—for pipes, conduits, cables, ducts, and similar building service equipment—have been installed with approved fire-rated materials and assemblies complying with Florida Building Code §714 and §715. The qualifying agent certifies that joints and penetrations meet ASTM E814, UL 1479, ASTM E1966, or UL 2079 testing standards and were installed per manufacturer specifications.
Who needs it
Qualifying agents or contractors submitting this affidavit with a permit to verify that fire-rated penetrations and joints in the building meet code compliance.
Why it needs a notary
The affidavit contains a sworn certification that must be notarized, confirming the qualifying agent's personal knowledge that fire-protection installations comply with Florida Building Code and testing standards.
Preview the form
The blank PDF straight from Medley. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed Florida online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.