Form HUD-92541 Builder's Certification of Plans, Specifications, & Site

Builder's Certification
of Plans, Specifications, & Site

U.S. Department of Housing
and Urban Development
Office of Housing
Federal Housing Commissioner

Property Address (street, city, State, & zip code)

Subdivision Name

Mortgagee's (Lender's) Name & Address (this is the lender who closed the loan)

FHA Case Number

OMB Approval No. 2502-0496 (exp.
08/31/2012)

Phone Number

NOTE: If any of 2,3 or 4 is checked "no", the property is ineligible for FHA insured financing
1 Site Analysis Information: To be completed on all proposed and newly constructed properties.
a. Flood Hazards. Are the property improvements in a Special Flood Hazard Area (SFHA)?

YES

NO

1) Provide the community number and date of the Flood Insurance Rate Map (FIRM) used to document your answer.
Community Number

Map Date

2) Is the community participating in the National Flood Insurance Program and in good standing?
3) If "Yes" to 1a. above, attach:
(i) a Letter of Map Amendment (LOMA) or;
(ii) a Letter of Map Revision (LOMR) or;
(iii)a signed Elevation Certificate documenting that the lowest floor (including basement) is built in compliance with
24 CFR 200.926d(c)(4).
4) Is the property located within a Coast Barrier Resource System (CBRS)? (if yes, the property is inelgible for FHA insured financing)
Items b-f see additional instructions on page 3
b. Noise. Is the property located within 1000 feet of a highway, freeway, or heavily traveled road?
Within 3000 feet of a railroad?
Within one mile of a civil airfield or 5 miles of a military airfield?
c. Runway Clear Zones / Clear Zones. Is the property within 3000 feet of a civil or military airfield?
If "Yes," is the property in a Runway Clear Zone / Clear Zone?
d. Explosive /Flammable Materials Storage Hazard. Does the property have an unobstructed view, or is it located within
2000 feet of any facility handling or storing explosive or fire prone materials?
e. Toxic Waste Hazards. Is property within 3000 feet of a dump or landfill, or a site on an EPA Superfund (NPL)
list or equivalent State list?
f. Foreseeable Hazards or Adverse Conditions.
(1) Does the site have any rock formations, high ground water levels, inadequate surface drainage, springs, sinkholes, etc.?
(2) Does the site have unstable soils (expansive, collapsible, or erodible)?
(3) Does the site have any excessive slopes?
(4) Does the site have any earth fill?
If "Yes," will foundations, slabs, or flatwork rest on the fill?
If you marked "Yes" to any of the above questions in f, please attach a copy of the State licensed engineers' (soils and structural)
reports, designs, and/or certifications showing compliance with HUD requirements to ensure the structural soundness of the
improvements and the health and safety of the occupants. Refer to HUD Handbook 4145.1 and HUD Handbook 4140.3 pg. 64-92.
2
3

Complete this section for all properties. The property complies with:
HUD Minimum Property Standards in the Code of Federal Regulations at 24 CFR 200.926d.
HUD Handbook 4145.1, Architectural Processing & Inspections for Home Mortgage Insurance, including Appendix 8, Site Grading &
Drainage Guideline.

4

IECC ( International Energy Conservation Code) 2006

5

Other Code or Local/State Code as follows:
Applicable Provisions

6
7

CABO One- and Two-Family Dwelling Code, as listed in 24 CFR 200.926b, replaced by IRC (International Residential Code)
Electrical Code for One- and Two-Family Dwellings, as listed in 24 CFR 200.926b, or equivalent, name code:

8

This is a manufactured (mobile) home and was constructed in accordance with the Federal Manufactured Home Construction & Safety
Standards (FMHCS). The label on the manufactured home shows compliance with the FMHCS. I hereby certify that the plans and
specifications for all other construction (i.e., site, foundation) comply with the applicable building code or HUD requirement listed
above, including paragraph. 3-4, Handbook 4145.1,and the Permanent Foundations Guide for Manufactured Housing.
HUD Label Number(s):

Builder or Builder's Agent: I hereby certify that the site analysis information above is true and accurate to the best of my knowledge and belief and that the plans and
specifications were designed to mitigate any foreseeable hazards or adverse conditions. On all properties eligible for maximum LTV financing, I further certify that I
have personally reviewed the plans, specifications, and site information submitted herewith . Based upon my review, I hereby certify that such plans, specifications
comply with the applicable building codes specified above as well as complying with the HUD construction requirements listed above. An "X" marked in the blank
PreviousbyEditions
are Obsolete
Page 1 of 3
Handbook 4145.1 form HUD-92541 (10/2012)
each numbered
item indicates that provisions from the marked code apply.

Builder or Builder's Agent: I hereby certify that the site analysis information above is true and accurate to the best of my knowledge and belief and that the plans and
specifications were designed to mitigate any foreseeable hazards or adverse conditions. On all properties eligible for maximum LTV financing, I further certify that I
have personally reviewed the plans, specifications, and site information submitted herewith . Based upon my review, I hereby certify that such plans, specifications
comply with the applicable building codes specified above as well as complying with the HUD construction requirements listed above. An "X" marked in the blank
by each numbered item indicates that provisions from the marked code apply.
9a. Name of Builder's Company or Builder's Agent (type or print)

10 a. Name & Title of Builder or Builder's Agent (type or print)

b. Street Address

b. Signature of Builder or Builder's Agent Date

c. City, State, & Zip Code

c. Telephone Number (include area code)

11 Affirmative Fair Housing Marketing Plan (AFHMP) Did you sell five (5) or more houses in the last twelve (12) months or do you intend to
sell five (5) or more houses within the next twelve (12) months with HUD mortgage insurance?

Date

YES

NO

If "Yes," check either a, b, c, or d below.
a. I am a signatory in good standing to a Voluntary Affirmative Marketing Agreement (VAMA).
b. I have an AFHMP which HUD approved on (mm/dd/yyyy)
to market this house.

c. I have a contract with

d. I certify that I will comply with the following: (a) Carry out an affirmative program to attract all minority and majority groups to the housing for initial sale
or rental. Such a
program shall typically involve publicizing to minority persons the availability of housing opportunities regardless of race, color, religion, sex, handicap,
familial status or national origin, through the type of media customarily utilized by the applicants; (b) Maintain a nondiscrimination hiring policy in recruiting
from both minority and majority groups; (c) Instruct all employees and agents in writing and orally in the policy of nondiscrimination and fair housing; (d)
conspicuously display the Fair Housing Poster in all Sales Offices, include the Equal Housing Opportunity logo, slogan and statement in all printed material
used in connection with sales, and post in a prominent position at the project site a sign which displays the Equal Opportunity logo, slogan or statement, as
listed in 24 CFR 200.620 and appendix to subpart M to part 200. I understand that I am obliged to develop and maintain records on these activities, and to
make them
available
HUD
uponinformation
request. is true and accurate to the best of my knowledge and belief. On all properties eligible for maximum LTV
Builder: I hereby
certify
that the to
site
analysis
financing, I further certify that the plans and specifications submitted herewith have been reviewed by the individual signing above and that the individual has the
knowledge and experience necessary to determine whether such plans and specifications comply with the HUD/FHA requirements set forth at 24 CFR 200.926d and with
other applicable HUD requirements as determined in accordance with 24 CFR 200.926(d)(1) and ( 2). Any subsequent changes to these plans and specifications shall
comply with the aforementioned requirements. Upon sale or conveyance of the property, the undersigned will promptly furnish to lender a Warranty of Completion of
Construction, form HUD-92544 on all properties eligible for maximum LTV financing.
12 a. Name of Builder's Company (type or print)

13 a. Name & Title of Builder (type or print)

b. Street Address

b. Signature of Builder

c. City, State, & Zip Code

c. Telephone Number (include area code)

Date

Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1 0 10 , 1012; 31 U.S.C. 3729,
3802).
This form must be complete and legible and must be reproduced to include all three pages.
Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. For addition information or questions
please call 202-402-2657. This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control
number.
Executive Order 11988 and HUD environmental regulations (24 CFR Part 51) require builders who build newly constructed properties s to ensure that the property is not
affected by: flood hazards, noise, runway clear zones, explosive/flammable materials storage hazards, toxic waste hazards, and other foreseeable hazards that may affect
the site. HUD requires this information to determine whether the site/location factors would adversely affect the dwelling or homeowner. A response is required
whenever a builder builds new properties. Confidentiality is not applicable.

Previous Editions are Obsolete

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Handbook 4145.1 form HUD-92541 (10/2012)

Instructions for Builder's Certification, form HUD-92541
Items 9 & 10. The builder or the builder’s agent must complete and sign these
items. If the builder’s agent completes and signs these items the builder’s agent is
certifying that builder’s agent has the knowledge and experience to determine
whether the plans and specifications comply with HUD/FHA requirements set
a. Flood Hazards: HUD prohibits new construction in Special Flood
Hazard Areas unless there is a Letter of Map Amendment (LOMA), a Letter forth in 24 CFR 200.926d and with other applicable HUD requirements in 24
CFR200.926(d)(1) and (2). The builder’s agent is further certifying that the
of Map Revision (LOMR), or an Elevation Certificate in accordance with
information about the site is accurate to builder's agent's best knowledge and
24 CFR 200.926d(c)(4) provided to the lender.
belief.
Items 1b.-f The builder must provide this information for all properties. If Item 11. If a builder has sold or intends to sell five (5) or more newly constructed
the property is a condominium, the builder may have to mitigate the site
properties within a twelve (12) month period, the builder is required to have one
issue if the project has not yet been approved by HUD.
of the following:
Item 1. Site Analysis: All builders must answer all the questions in this
item. An addendum may be added, if necessary, to provide a full
explanation about any of the site conditions listed.

b. Noise: Self-explanatory.
c. Runway Clear Zones/Clear Zones: If the property is located in a
Runway Clear Zone / Clear Zone, the lender must require, as a condition of
borrower approval, that the borrower will sign a statement acknowledging
receipt of the notification required by 24 CFR 51.303(a)(3).

a. Be in good standing to a Voluntary Affirmative Marketing Agreement
b. Have a HUD approved Affirmative Fair Housing Marketing Plan (AFHMP); or
c. Have a contract with a Marketing Agent to implement its approved AFHMP;
or a contract with a Marketing Agent with signatory to a National Association of
Realtors
or
d.
CertifyVAMA;
to the requirements
which are hereby listed, taken from 24 CFR

d. Explosive/Flammable Materials Storage Hazard: Self-explanatory.
e. Toxic Waste Hazards: Self-explanatory.
f. Foreseeable Hazards or Adverse Conditions: Self-explanatory.
Items 2 - 8: The builder/builder’s agent must complete these items as
follows:

Items 12 & 13. The builder must complete and sign Items 12 and 13. The
certification is self-explanatory. All changes to the original form must be initialed
and dated by the builder.
Appraiser / Direct Endorsement Lender's Responsibility
FHA Roster Appraiser. The appraiser must receive a fully executed form HUD92541 before performing the appraisal on proposed or under construction
properties or properties less than one year old and never occupied.

Items 2, 3&4. Place an "X" in the box in Items 2, 3 and 4. The certified
builder must complete Items 5 thru 8 as follows:

The appraiser must review Item 1 and note in the Appraisal Report any
Item 5. The local/State code in Item 5 is the accepted code for a locality.
The additional requirements needed from the Table in 24 CFR 200.926c, to discrepancies between the information in Item 1 and the actual conditions
observed on site. The appraiser must take into consideration the effects of any
supplement a partially acceptable local code, must be shown in Item 5.
Item 6. When the whole CABO Code is used as the HUD referenced code site conditions on the value of the property.
in jurisdictions with “no code” or an “unacceptable code,” place an “X” in
the box in Item 6 and place the word “All” in the space.
Item 7. Place an “X” in the box on line 7, and, if applicable name
equivalent code.
Item 8. If the dwelling is a manufactured (mobile) home, place an “X” in
the box in Item 8. Properly complete lines 4 through 7 for all “foundation
and site work.” Insert the HUD label number(s) in the box provided.

Previous Editions are Obsolete

Direct Endorsement Underwriter. The DE Underwriter must review the
Appraisal Report and the Builder Certification as part of the underwriting
process, taking into consideration the effect of any site conditions on the value of
the property. Page 1 of this form must be complete and legible. Only the builder
or the builder's agent is authorized to complete or change this form. The DE
Underwriter cannot change and/or modify this certification form.

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Handbook 4145.1 form HUD-92541 (10/2012)