535 Pelican Key - Revision Request/Corrections CITY OF ATLANTIC BEACH
800 Seminole Road
Atlantic Beach,Florida 32233
REVISION REQUEST/CORRECTIONS TO PLAN REVIEW COMMENTS
DateI I � Revision to Issued Permit_zcorrections to Comments_ Permit#
Project Address S 3 S k'k'CA-(� 1 eN
Contractor/Contact Name ��,�i�Dok �-06 �►
Phone Ot — a"DLEmail
Description of Proposed Revision/Corrections: Permit Fee Du $ 6 :5. CC)
Additional Increase in Building Value $ Additional S.F.
By signing below,I affirm the Revision is inclusive of the proposed changes.
(printed name)
Signature of Contractor/Agent(Contractor must sign if increase in valuation) Date
(Office Use Only)
Approved ^ Denied Not Applicable to Department
Revision/Plan Rev' w Comments 60 �1'd C/c/rt 60 t, a c T r S 'ec &t U'/ke r h.IL
atrriv2S a s'o!o st
ment Review Required:
Building
Plannin ing Reviewed By
Tree Administrator
Public Works
Public Utilities
Public Safety Date
Fire Services
City of Jacksonville
PERMIT NO.
Planning and Development (; F — (D4
Building Inspection Division
APR 2018
OFFICE USE ONLY
- �
Application for: Approved by: /YI
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 913-0475. 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.
Before me this day of _in the County of Duval,State of Florida,
has personally appeared f 57Lt a' herein by
-/ himself/herself and i s all stat ents and declarations herein are true and
Z,/—Wl/Signed: ' accurate.
KYLE MAX11lfE blic at arge tate of PL_ County of�L AL_
sona y known or Produced Identification
MY COMMISSION#FF?2"":
�'► „ EXPIRES June 13.2019
14071398x•93 Ffor alloa-vSormaaw
Contractor Affirmation
Company: /rzz t— C'7— PCO r/A/ a- ddA157*_L,'77U,Q ® 0 —
Address of Project: /'nd lbs"^i
Requested By: u E .'i%fi��'wELL a�in 4s ne�� - yon/-.T =90 Sir
Reason for Request: - f= Fo �� GAI
understand City of Jacksonville Building Inspection Division procedures
as outli d 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.
Signed: Date: /S 6�7 X-49E
An Approved Copy of this Application Must be On-Site at Time of Destructive Roofing-In-Progress Inspection
Ak Cash Register Receipt
City of AtlanticBeach R4798
DESCRIPTION • CITY •
PermitTRAK $165.00
RERF18-0044 Address: 535 PELICAN KEY APN: 172027 5586 $165.00
REINSPECTION $55.00
REINSPECTION 455-0000-322-1002 0 $55.00
WORK WITHOUT PERMIT $110.00
WORK WITHOUT PERMIT 455-0000-322-1000 0 $110.00
TOTAL FEES PAID BY RECEIPT: R4798 $165.00
Cii14ARAN[h BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
041/1T2018 13.10:50
CREDIT CARD
VISA SALE
Card XXXXXXXXXXXX6102
SEQ 2
Bath#: 586
INVOICE 2
Approval Code: 044411
Entry Method: Manual
Mode: Online
Card Code: M
SALE AMOUNT $165,00
CUSTOMER COPY
Date Paid: Tuesday, April 17, 2018
Paid By: BIGFOOT ROOFING & CONSTRUCTION
Cashier: BA
Pay Method: CREDIT CARD 2
100
Printed:Tuesday,April 17,2018 1:11 PM 1 of 1 j
RaaT