95 97 W 2nd St Destructive Roof-In-Progress OFFICE COPY
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'' City of Jacksonvil le PERMIT NO.
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Planning and Development RES C I — 4 (
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e Building Inspection Division
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/ OFFICE USE ONLY
Application for: / 1)prd1feOf' T �d Approved by: rn
Destructive Rolf' g-In-Progress g In Progress Inspection Date Approved: r:; " 3 -do ZC)
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.
Befor, • his day of in th oun y of Duval,Stake,of Florida,
has p: .11yapp - ed C.) p t vy
f himse erself a flitall state . . .eclarations herein are true and
Signed:,--"'_„ijjgIIIIIIIIIIIIIIIIa rat:
.....4;....,,,, TONT GINDLEBP Own:' Notary Public at Large,State of ,Count of - 01/0--(
,.. ' MY COMMISSION#GG 353178 I G Y
*: 'r r ;*? Personally known ,or Produced Identification
"A•,' •o: EXPIRES:October 6,2023 -.43c.,,+ y_. ID Type: -.43c.,, q 3c:7 -6:,s-o2( -
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Co tr ctor Affirmation
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Company: AyI- .;/ , ! i
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Address of Project: —9 i is ‘• A'' AMIrI/L G rte`
Requested By: —VIPC
Reason for Request: _ ..A ( At MEQ ' c _ / , t ,
7Y/ ' M Z'374 ` 4
� , 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.
Signed;/ , ��D
Date:
An Approved Copy of, A pplication Must be On-Site at Time of Destructive Roofing-In-Progress Inspection