1226 HIBISCUS ST RERF18-0235 DESTR ROOFG INSP c,.Q ( camS ci ,ik 12-7-p
;;' City of JacksonvillePE IT NO. 6 12_/- ( 7-- D -3s
- j Planning and Development
�� cccc>
Voy 4 x„04 ; Building Inspection Division
%CksOiont-f.
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 .11 state and local codes.
Apt/dr Before me th�1"day the County of Duval,State of Florida,
has persona II y appeare ("19L,v. AS:2-w herein by
,, himself/herself and affirms all staterr�ents and declarations herein are true and
Signed: lir
/ accurate.Property Owner � � T-blic at Lar e,State A�; - - ounty oT/VAa-G-
/ erson n L----or Produced Identification
1 ID Type: I- -
�1:ii WIWAM R.ROHM,JR
I s t '""' : EXPIRES Ap.v►26,2O2,
Contractor Affirmation I ''��„1,2 BondedlhruNotaryPublicUnde,writers
1 /�
Company: 4 ,A_ --7
Address of Pro'- : ��� _v � le4,-,
,'
Requested By: fill_ _,_ ,
Reason for Request: j • �` '
I' _ 0 , understand City of Jacksonville Building Inspection Division procedures
as outlined in F.ulletin 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: `. /j r
An Approved Copy of this Application Must be On-Site at Time of Destructive Roofing-In-Progress Inspection