435 Selva Lakes Cir RERF18-0148 �:,l , CITY OF ATLANTIC BEACH
t`' 800 Seminole Road
--a....,'�.. "s' Atlantic Beach,Florida 32233
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REVISION REQUEST/CORRECTIONS TO PLAN REVIEW COMMENTS
Date D3 17 Revision to Issued Permit Corrections to Comments Permit#676--Ul 4
Project Address 435 Je.( v&L, \leS CI r
Contractor/Contact Name / t A k Poo Fro A-ErEes
Phone Email
J1r"11%
Description of Proposed Revision/Corrections: Permit Fee Duel$ IE --
'-De5 ,ccii-v gc„i-- ( Yl rPr6 9-ress
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 g*---- Denied Not Applicable to Department
PP PP P
Revision/Plan Review Comments
De artment Review Required:
Buildin
Planning & Zoning Reviewed By
Tree Administrator
Public Works ey---v
Public Utilities U .. 7 /
Public Safety Date
Fire Services
/4- -
''f,tCity of J�rtg PERMIT N0.
\1 l2'� !i`; Planning and Development ereF / 6 --0/9
�. ; ��`;' Building Inspection Division
✓4eksox"" - 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 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.
Before me this lay of Aouq✓s'f-in the County of Duval,State of Florida,
/ has personally appeared 1.). 11•)IS A/a14.¢f'�.1 herein by
himself/herself and affirms all statements and declaratio herei, _+.•true and
Signed• V- II accurate.
/ Property Owner � P• ? _ '
Notary Public at Large,State of r/ort„ ,Cou it of
Personally known 4-". or Produced Identification
ID Type:
1 • ":'v'''' MARK)PAUL HERRERA 0
',.��.�,`t.c Notary Public-State of Florida
Contractor Affirmation ' • Commission#GG 128391
My Comm.Expires Jul 2u,2u2 r
f!\pa p # `".'F°F Bonded through National Notary Assn.
f!Company: i-0D �4c 4 �nL-. •- - --- - - --- �.
Address of Project: `"t .5 5 S IVU 1611 -es C 1 L c'
Requested By: A144-1 P--O g n 161 I k[L(
Reason for Request: V C,SA y kA( , V-VU k- T r
LBuildingI, 11CVk Uk , understand City of 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 - assessment of additional re-inspection fees.
Signed: / Date: 0p70 7.V0
i/tJ
An Approve,,, 41of this Application Must be On-Site at Time of Destructive Roofing-In-Progress Inspection