667 SELVA LAKES CIR - DESTRUCTIVE ROOFING 1 2 Pb21
City of Jacksonville 'll0'/ PERMIT NO.
Planning and Development \ \w �� /.0R ' 3)3 6
5 Building Inspection Division `\
OFFICE USE ONLY
Application for: Approved by:
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 9B-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. I 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 verify
work is in compliance with all state and local codes.
f c201.7Before me this day of v in e County of Duval,State of Florida,
has personally appeared t ► ��, 1�j�.�r� /, herein by
himself/herself and affirms all stateafents and declarations herein are true and
g accurate. /
Signed: /('' 3 J
Property Owner Notary Public at Large,State of 5 / ,County of /�/v✓cc_
Personally known_r or Produced Identification✓'
ID Type: _ _ _
.•iµ1`,,,•.,, PAUL ROBERT CASSETTA
, � ' Nutery Public-State LA Florida
Contractor Affirmation • Commission rCIG 126370
Ady Comm.Erplw Jul 2d,2021
t G1. ' 0F Bordedthrough National Notary Assr.
Company: 3Q�Fi'i'D (Ji/404-s 42U0�7Q�
Address of Project: 7 J"Gfi(//9 L4'k-`I (i-kde
Requested By: 3rl7414 4y/k)
Reason for Request: 71 D
I,
Jege../44-tv ��'Zi , understand City of Jacksonville Building Inspection Division procedures
as outlined in Bulletin G-04-08. I 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.
Ae
Signed: A - Date: /r7-7�
An Approved Copy of this Application Must be On-Site at Time of Destructive Roofing-In-Progress Inspection