128 Seminole Road #11 Destructive Roof Inspection City of Jacksonville PERMIT N0.
�c Planning and Development ' `E R` .2 C v 1 `
`f Building Inspection Division
OFFICE USE ONLY
Approved by:
Application for:
Destructive Roofing-In-Progress Inspection Date Approved:
ROOFING-IN-PROGRESS INSPECTIONS
A Roofing-In-Progress Inspection is a required inspection per the Florida Building Code—Existing Building (FBC-EB).
The purpose of the inspection Is to confirm any required deck nailing has been completed and proper installation of a
secondary water barrier as required by Rule 98-0475. This required inspection was not requested by the contractor
prior to completing the shingle installation for the above referenced permit, and now a Destructive Roofing-In-
Progress inspection must be performed by removing certain portions of shingles and/or underlayment to insure
compliance with state law. Not complying with this requirement could affect your insurance coverage for storm
damage.
Owner Affirmation
I understand that the contractor, for the reason listed below, was unable to acquire a Passed Roofing-in-Progress
Inspection. 1 also understand the Destructive Roof in Progress Inspection will require the Contractor to remove and
replace shingles and/or underlayment as required by the City of Jacksonville Building Inspection Division to ve*
work is in compliance with all state and local codes. 'I'� /
Before me[hIs day of I~Bre l I the Cou t pfDuval, Wteof"mx` ,
hl'..P onall ap ared (�- l4 herein by
Ql�J ,� himu hersei datin I ents and K d[IMs herein act true and
(1 /l9/00! auurn
Signed
Property Owner Notaryllykinoxii e,State I ,Cou
Personalty known or Protluoed ldemifla[ion_
TONI GINDLESPERGER IOTyPe: 7� —�
My COMMISSION 0 GG 367178
P:
Contractor Affirmation
Company:
Yore Co���c`F to
Address of Project ( zC� �M t R C)I� `
Requested By:
Reason for Request:
understand City of Jacksonville Building Inspection Division procedures
as outlined in Bulletin G-04-0e. 1 also understand the Destructive Roofing-in-Progress inspection is not part of those
procedures and is an exception to the procedure. In addition, I understand that any non-code compliant work identified during
this inspection may result in the assessment of additional re-Inspection fees.
Signed: Date:
An Approved Copy of this Application Must be On-Site at Time of Destructive Roofing-In-Progress Inspection