HomeMy WebLinkAboutNotice to Building Official of Use of Private Provider$ s
Notice to Building Official of
Use of Private Provider
Project Name. Creekside Plat #4, Lot # 46 @ 3306 Trinity Cir, Fort Pierce
Parcel Tax ID: 2327-502-0054-000-4
Services to be provided: Plans Review Inspections
Note: If the notice applies to either private plan review or private inspection services the Building
Official may require, at his or her discretion, the private provider be used for both services
pursuant to Section 553:791(2) Florida Statute.
I D. R. Horton Inc.
the fee owner, affirm I have entered into a contract with the Private Provider indicated below to conduct
the services indicated above.
Private Provider Firm: Universal Engineering Sciences, Inc.
Private Provider: Richard E. Hoaglin. Professional Engineer
Address: 820 Brevard Avenue, Rockledge Florida 32955
Telephone: ' 321-638-0808 Fax: 321-638-0978
Email Address (Optional): RHoaglinouniversalengineering.com
Florida License, Registration or Certificate #: Florida License No. 48976
I have elected to use one or more private providers to provide building code plans review and/or
inspection services on the building that is the subject of the enclosed permit application, as authorized by
s. 553.791, Florida Statutes. I understand that the local building official may not review the plans
submitted or perform the required building inspections to determine compliance with the applicable codes,
except to the extent specified in said law. Instead, plans review and/or required building inspections will
be performed by licensed or certified personnel identified in the application. The law requires minimum
insurance requirements for such personnel, but I understand that I may require more insurance to protect
my interests. By executing this form, I acknowledge that I have made inquiry regarding the competence of
the licensed or,certified personnel and the level of their insurance and am satisfied that my interests are
adequately protected. I agree to indemnify, defend, and hold harmless the local government, the local
building official, and their building code enforcement personnel from any and all claims arising from my
use of these licensed or certified personnel to perform building code inspection services with respect to the
building that is the subject of the enclosed permit application.
I understand the Building Official retains authority_to review plans, make required inspections, and
enforce the applicable codes within his or her charge pursuant to the standards established by s. 553.791,
Florida Statutes. If I make any changes to the listed private providers or the services to be provided by
those private providers, I shall, within 1 business day after any change, update this notice to reflect such
changes. The building plans review and/or inspection services provided by the private provider is, limited
to building code compliance and does not include review for fire code, land use, environmental or other
codes.
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The following attachments are provide as required:
1. Qualification statements and/or resumes of the private provider and all duly authorized
representatives.
2. Proof of insurance for professional and comprehensive liability in the amount of $1 million per
occurrence relating to all services performed as a private provider, including tail coverage for a
minimum of 5 years subsequent to the performance of building code inspection services.
Individual
(signature;)
Print
Name:
Address:
Telephone
No.
Please use appropriate notary block.
STATE OF Florida
COUNTY OF Brevard
Individual
Before me, this day of
20_, personally
appeared
who executed the foregoing instrument,
and acknowledged before me that same
was executed for the purposes therein
expressed.
Corporation
DR Horton Inc
Print Corporati Name
By:
(signature)
Print
Name: Brian W. Davidson
Its: Assistant Secretary
Address: 1.430 Culver Dr NE,
Palm Bay, FL 32907
Telephone
No. 321-733-7072
Corporation
Partnership
Print Partnership Name
By:
(signature)
Print
Name:
Address:
Telephone
No.:
Before me, this 9 day of
October , 20 2R
personally appeared
Brian W. Davidson of
DR Horton Inc , a
corporation, on
Behalf of the state corporation, who
executed the foregoing instrument and
acknowledged before me that same was
executed for the purposes therein
expressed.
Partnership
Before me, this day
of , 20_, personally
appeared
partner/agent on behalf of
a partnership, who executed the
foregoing instrument and acknowledged
before me that same was executed for
the purposes therein expressed.
Personally known ✓ ; or Produced identification Type of identification produced
Signature of Notary Print Name
Notary Public: NOTARY STAMP BELOW
►;' .
My commission expires: •,gip:, w,�;. DINAPARRINO
MY COMMISSION # GG 935643
Po EVIRES: February27, 2024
''• ? oYP�O . Bonded Thru Notary kbltc Underwriters
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