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HomeMy WebLinkAboutRevisions/ CHANGE OF PRIVATE PROVIDER OFFICE USE ONLY: n �f,, DATE FILED: U o,( o ""9- -2 l PERMIT# d 011 Q W( REVISION FEE: � 7j RECEIPT# PLANNING&DEVELOPMENT SERVICES BUILDING&CODE REGULATION DIVISION 2300 VIRGINIA AVENUE FORT PIERCE,FL 34982-5652 (772)462.1553 RECEIVED APPLICATION FOR BUILDING PERMIT REVISIONS PROJECT INFORMATION FHB 2 5 2021 LOCATION/SITE oerr Itono�partment St. Lucie County ADDRESS: R30 W11A)�61- GttirdeN Oi<jw� DETAILED DESCRIPTION OF PROJECT REVISIONS: ,J CONTRACTOR INFORMATION: STATE of FL REG./CERT.#: CGC1517458 ST. LUCIE CO CERT. #: 31830 BUSINESS NAME: WJH FL LLC QUALIFIERS NAME: MOREY DOYLE ADDRESS: 3091 Govenors Lake Drive,Suite 300 CITY: Norcross STATE: GA ZIP: 30071 PHONE(DAYTIME): (321)270-6629 FAX: NA OWNERMUILDER INFORMATION: NAME: WJH FL LLC-Morey Doyle ADDRESS:3091 Govenors Lake Drive,Suite 300 CITY: Norcross STATE: GA ZIP: 30071 PHONE(DAYTIME: (321)270-6629 FAX: NA ARCHITECT/ENGINEER INFORMATION: NAME: Mulhem&Kulp ADDRESS: 300 Brookside Ave CITY: Ambler STATE: PA ZIP: 19002 PHONE(DAYTIME): (215)646-8001 FAX: NA SLCCC: 9123109 "Rh EV I S I Revised 06130/17 MRS / WEINTRAUB INSPECTIONS&FORENSIC,INC. Notice to Building Official of Use of Private Provider Pro ect Name: n 6,cAeA) PKI,& �12H Fl- LL6 J (1 O- Parcel Tax ID: 13 01 — 60S_ 03 r`ry " 000 Services to be provided: Plans Review_ Inspections V[Building Pool_Other I 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 �o el4 the fee owner,affirm I ha entered int64 contract with the Private Provider indicated below to conduct the services indicated above. Private Provider Firm: Weintraub Inspections&Forensics Private Provider: Jerry M Weintraub Address: 3868 Sun City Center Blvd.,Sun City Center,FL 33573 Telephone:813-633-8000 Fax:813464-M Email Address(Optional):jwolfersbergerr.&weintraubinspections.com Florida License,Registration or Certificate:Professional Engineer 30033 1 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 I 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. 3868 Sun City Center Blvd. Phone: 813-633-8000 Sun City Center,FL 33573 Fax:813-4648026 WEINTRAUB INSPECTIONS&FORENSIC,INC. The following attachments are provided 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 Corporation Partnership lj)tfi i fit_ LLC, Print Corporation Name Print Partnership Name By: By: (signature) (signature) (signature) Print Print Print Name: Na : Name: Address: Its•, i. � Its• Address: Address: Telephone �Qrl/ DVP„/4A1_P /_G Se/I No.: &4 906171 Telephone 1 Telephone No. No.: Please use appropriate notary block. 1 STATE OF COUNTY O rot Corporation Partnership Before me,this day of Before me,this_�day of Before me,this day 20 ,personally ',ph ,20� of 120 personally appeared personally aRpeared appeared who executed the foregoing instrument, of partner/agent on behalf of and acknowledged before me that same (,�:5 M r'�. .LL ,a was executed for the purposes therein corporation,on a partnership,who executed the expressed. behalf:of the state corporation,who foregoing instrument and acknowledged executed the foregoing instrument and before me that same was executed for acknowledged before me that same was the purposes therein expressed. executed for the purposes therein expressed. i Personally known ;or Produced identification Type of identification produced Signature of Notary Print Name Notary Public:NOTARY STARNowy Pusi[e> r of Feor Hesow C DahM My commission expires: HH QW0 i . I 3868 Sun Cite Center Blvd.Sun 2 of 2 Phone: 813-633-8000 Ciry Center.FL 33573 Fax:813-4648026 FORM # 9B-3.053-2005-01 JOB SITE PRIVATE PROVIDER IDENTIFICATION FORM Florida Building Commission Effective February 1,2006 PROVIDER NO. 1 Primary Contact: Jon Wolfersber er Email address jwolfersberger@weintraubinspections.com Telephone Number: 321-474-1459 Fax Number: 813-464-8026 License number PE 300033 Company: Weintraub Engineering EngineeHng and Inspections, Inc. Address: 3868 Sun Citv Center Blvd Ruskin FL 33573 Job address Specific project on job site Permit number Type.of Service Being Performed: Building Inspections Insurance policy GL 10006 number Signed rovider PROVIDER NO.2 Primary Contact: Email address Telephone Number: Fax Number: License number Company: Address: Job address Specific project on job site Permit number Type of Service Being _ Performed: Insurance policy number Signed by Provider DATE(MM/DD/YYYY) ACC)R" CERTIFICATE OF LIABILITY INSURANCE 02/03/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not.confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Erin Condlin NAME: Johnson&Company PHONE., Ext: (407)843-1120 aC No): (407)843-5772 801 N Orange Avenue E-MAIL ADDRESS: Suite 510 INSURER(S)AFFORDING COVERAGE NAIC# Orlando FL 32801 INSURERA: FCCI Insurance Company 10178 INSURED INSURER B: Brldgefleld Casualty Insurance 10335 Weintraub Engineering and Inspections,Inc. INSURER C: Continental Casualty Company 20443 Weintraub Inspections&Forensics INSURER D: 3868 Sun City Center Blvd INSURER E: Sun City Center FL 33573 INSURER F: COVERAGES CERTIFICATE NUMBER: CL20111214948 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AUDL15UI3R1 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A A 100,000 CLAIMS-MADE Fx_]OCCUR PREMISES Ea occurrence $ MED EXP(Anyone person) $ 10,000 A GL100063261 11/15/2020 11/15/2021 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY�JJE LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: Employee Benefits $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident Ix ANYAUTO BODILY INJURY(Per person) $ AOWNED SCHEDULED CA100063259 11/15/2020 11/15/2021 BODILYINJURY(Peraccident) $ AUTOS ONLY AUTOS HIRED �/ NON-OWNED PROPER'Y DAMAGE $ AUTOS ONLY /� AUTOS ONLY Per accident Drive other car $ X UMBRELLA LIAB M OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE UMB100063260 11/15/2020 11/15/2021 AGGREGATE $ 5,000,000 DED I X1 RETENTION$ 10,000 $ WORKERS COMPENSATION X1 STATUTE ERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 B OFFICER/MEMBER EXCLUDED? FNqN/A 0196-51752 10/15/2020 10/15/2021 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Professional Liability Limit Per Claim $2,000,000 C MCH591943348 10/01/2020 10/01/2021 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Port St.Lucie Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 121 SW Port St.Lucie Blvd AUTHORIZED REPRESENTATIVE Building B Port St.Lucie FL 34984 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD WEINTRAUB INSPECTIONS & FORENSIC, INC. 3868 Sun City Center Boulevard Sun City Center, FL 33573 Phone: 813.633.8000 Fax: 813.464.8026 QUALIFICATION PACKAGE FOR PRIVATE PROVIDER Weintraub Inspectors and License Numbers: 1. Jerry Mark Weintraub PE30033 2. Usha Ramachandran PE73119 3. Jon Wolfersberger BN4874 4. Bobby J. McKinney BN983, PX2292 5. Henry Steven Bass BN5641, PX2964 6. Raymond Allen Will BN2651, PX1804 7. Steve Campbell BN6056 8. Jerome (Jerry) M. Schroeder BN7347 9. David Salmon BN7384 10. David Vines BU1409, BN4842, PX2504, SPF167 11. Allen A. Gillette BN6803, PX3777 12. Craig Baldinger BN7561 13. Eric McAfee BN7565 14. Michael Todoroff BN4856, PX2568 15. Mathew Hodges BN6730 16. James D Lloyd BN5101, PX3102 17. Orlando Wright BN461 Hw 2020 -2021 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT EXPIRES SEPTEMBER 30,2021 271253vurvi ' OCC.CODE RENEWAL 280.052005 CONSTRUCTION CONSULTANTS 10 Employees Receipt Fee 54.00 Hazardous Waste Surcharge 0.00 Law Library Fee 0.00 WEINTRAUB INSPECTIONS&FORENSIC, BUSINESS INC. 3868 SUN CITY CTR BL � a � 011 SUN CITY CTR,FL 33573 � a WEINTRAUB INSPECTIONS&FORENSIC,INC. NAME 3868 SUN CITY CENTER BLVD MAILING SUN CITY CENTER,FL 33573 ADDRESS Paid 19-0-407771 07/24/2020 64.00 BUSINESS TAX RECEIPT DOUG BELDEN,TAX COLLECTOR HAS HEREBY PAID A PRIVILEGE TAX TO ENGAGE 813-6355200 IN BUSINESS,PROFESSION,OR OCCUPATION SPECIFIED HEREON THIS BECOMES A TAX'RECEIPT WHEN VALIDATED. 1 p4 Sl9TA Ron DeSantis,Governor Halsey Beshears,Secretary Florida :r. �DWE�4�' STATE OF"'FLORIDA: _ . DEPARTMENT.OF BUSINESS-AND=P11,9FESSIONAL REGULATION BOARD OF� PRQEEESSIONAL GINEERS THE ENGINEER/pNG B'SIN SSfHERE^IN FS-AUwTH *`ZE{D UNDER THE PROVIS ONS`OF CH7� ,TER47FLORIDA STATUTES WEINT ' �U11 SPE T:� �,� FpR'E rr cc CONS NSI.0 INC. rNasuc� `868' U.N CITY ETERpBLVQ 4 S,U if ,CE,`TER FL 33ST3 ICEN�SE,UMBER:CA 28�353 EXPIRATIONzD�TE: _RUAR 28,2021 Always verify licenses online;at MyFloridaLicense.com. Do not alter.this document in any form: . This is your license.It is unlawful for anyone other than-the licensee to use this document. p4 �, Ron Mantis,Governor F.BPE _ _ ❑L' 'FLORIDA BOARD OF PROFESSIONAL'ENGINEERS' STATE OF FLORIDA: ".BOARD OF PROFESSIONAL ENGINEERS THE PROFESSIONAL EN.CI EER=_' ".RECNJS.LIG;NSED UNDER THE PROVISIONS-OFHAPTERI: 1;FLORID ATUTES WEtNTRAUBJ.ERtI� MAIRK 1' III 38 '8 SL�N CI -(' CE q TER BLVD ll UM C-IT�Y GE t iT,EIL-, FL�335Z ' LICER:gc UMEFER:PE30033 EXPIRATION DATE: FEBRUARY 28,'2023 Always verify licenses online at MyFloridaLicense.com RE IN Do not alter this document in any form. �� This is your license.It is unlawful for anyone other than the licensee to use this document. Ron DeSantls Governor -_ F.BPE_ FLORIDABOARD OF PROFESSIONALEINGNEERS STATE OF FLORIDA WE , BOARD OF PR -.F-SSIONAL ENGINEERS %_lei THE PROFESSIO 'L N. "E REIN' NDER'THE NA E C{ E IS U r PROVISIQNS OF' FIAPTER�`NQT FC A ST TOTES 3RdAMA s�G'; AN+DRZA — A��" +5059 SOUTH � t t -„ LICENSENUMBER:PEZ3 19 EXPIRATION DATE:,FEBRUARY.28,2023 ' Always verify`licenses online at MyFlo"ridaLicense.com Do not alter this document in any form:. � This is your license. It is unlawful-for anyone other than the elicensee to use this document of Ron DeSantis Governor Halsey Beshears Secretary r. ter . .STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL,REGULATION BUILDING'CODE AQPr�t11STI2, ORS & FNSPECTOR THE.STANDARD WPM O °E CESR_gqT. IED.UNDER THE ; PROVIS164SA F CNAPT R�46$V1=LOR1F' A .TUTES +^a X ` LICENS -NUh�IIBER:B 8 .4 EXPIRATION DATE-NOVEMBER'`3Q .Always verifylicenses online,at MyFlondaLicense com ❑■ ❑■ Do not alter this''0 ent in ;form. Y - ■ This is your license It'is unlawful for anyone'other than the licensee to use this-document pF Ro Ron DeSantis Governor Halsey Beshears Secretary .� Florida � :STATE OAF FLORIDA DEPARTMENT OF B.USIN..ES! AND-PROFESSIONAL REGULATION_,."..; BUILDING.CODE ADWIVISfiit'Ax ORS & INSPECTOR THE-STANDARD IfP�GT.®RQJE iEll�ds�15 To D'UNDERTHE , , FROVISIQ.NS OF�C CAPTERA FE RDA TATUTES . �411 � � � C`OURT I �1�33 CLF?i. � r3t7a� u• g , p_ LICE[VSENUMBER:8�43 'EXPIRATION DATE: 'NOVEMBER 30;2021 Always verify licenses online at My Li Do not alter this document m any form. This is your license. It is unlawful�for'anyone other than the licensee to use this document 0 y , pF Ron DeSantiS Governor Halsey Beshears,Secretary. - ter. + F _� STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL;REGULATION ., BUILDING CODE D.MIIiISTit'ATORS & INSPECTOR THE STANDARD PLA S ESXAL�[1N R'NEREI ISLE TI�FIED UNDER THE PRQVIS101K S,6F CHAR-PTErR 4'4 :FdORI,DA=STATUTES � - J �/IC NilIIVNt (,B0gB3Y=J Fes, r f13 �CL'0W, COURT E E ,F�L 34761 LICEIfSE NU( BER:P -f292 EXPIRATION-DATE: NOVEMBER 30i 2021 Always verify licenses online at MyFloridKicense.com 21 _ - ] Do not alter.this"document in any'form:, I• Thi's is your license.It is unlawfuFfor anyone,other than the,licensee to use this document ❑ r Ron DeSands,Governor Halsey Beshears,Secretary Florida d0pr STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS &INSPECTOR THE STANDARD PLANS EXAMINER HEREIN IS CERTIFIED UNDER THE PROVISIONS"OF CHAPTER 468- FLORIbA STATUTES v_ BLDG BASS, HENRY STEV*EN i PO BOX 5221 SUN CITY CENTER ;FL 33571 LICENSE NUMBER PX2964 EXPIRATION DATE: NOVEMBER 30,2021 Always verify licenses online at MyFloridaUcense.com Do not alter this document in any form. This is your license.It is unlawful for anyone other than the licensee to use this document. pF Ron DeSantis,Governor Halsey Beshears,Secretary o Florida dopr , STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMIN)tSTRATORS &INSPECTOR THE STANDARD INSRECTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS'OF CHAPTER3468 FLORIDA STATUTES BASS, HENRY STEUEN 1112 MANATEE AVENUE WEST - qd ,BRADENTON;i FL 34205 A. LICENSE NUMBER BN5641 EXPIRATION DATE: NOVEMBER 30,2021 Always verify licenses online at MyFloridaLicense.com o, a Do not alter this document-in any form. � This is your license.It is unlawful for anyone other than the licensee to use this document. Ron DeSantis Governor Halsey Beshears;Secretary Flonda Dpr •.STATE OF FLORIDA DEPARTMENT"OF BUSINESS AND PROFESSIONAL REGULATION ,. BUILDf;N.G CODE ADMfNIATM TORS & INSPECTOR THE STANDARD NSPECTi R H'EREIMS CERTI'kj D UNDER.THE FROVISIONSOF GH PTER4'1�8�F�OR1 ATATUTES BLDG -- - 71 _ TTT iMC�►FE�E; ERI'C D'ENE • ��527d�PRES DENTIAL S= - ' - " LICENSE NUMBER: EXPIRATION'DATE: NOVEMBER 30;2021 ' Always verify:licenses online,at MyFloridaiLicense.com . Do.not alter this document in,any-form... This is your license. It is-unlawful for ariyone'other than the licensee to use this;document.' " pF T o Ron DeSantis Governor Halsey Beshears Secretary Flonda �y� STATE OF FLORLDA D.,EPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING'CODE AD SOBS & INSPECTOR THE STANDARD °SPGT. Ett�(1RgR D UNDER THE RROVISIONSC�FTER`46'$:F�OR1. AST .TUTES DIM 4�0 ?OUEt DR POR I'Ct Y FL 346 r IM =T LIC.EI S Ni1MBER:PIW7,561 EXPIRATION DATE: NOVEMBER 30;'2021 Always venfy`licenses onlme:at MyFlondaLicense com L Do not alte'thi 'document in any form This is your license It is unlawful for anyone other-than the licensee to use this-document pF Ron DeSantis Governor Halsey Beshears Secretary Z. Flonda ' ���STATE OF.FLORLDA' {mob ` DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ;BUILDING CODE DNl�IIST x ORS &,INSPECTOR H T E STANDARD SPE R _IS CFRTI t'D UNDER.THE .- . PROVISIQ. S46 = L TUTE S LICE S IBER:B,,7384 EXPIRATION:DATE: NOVEMBER 30,2021 Always verify icenses online:at MyFbridaLicensecori Do,not alter.this.docume,nt in any form �� This isyour license.It is unlawfuf for anyone other,than th dicensee to use this document dk Ron Desantis Governor Halsey, ary Beshears,secret oor, ":STATE OF FLORIDA DEPARTMENT OF BUSINESS AND-PROFESSIONALREGULATIO.N' BUILDING'CODE ADMtWSTRAXORS &INSPECTOR RIM THE STANDARD ICI§5P CTOR NI REI 'Al: �1ED UNDER THE FROVISIONSOF'CN_AP3TER�`4'6`$ Ft�ORI'=A S IATU.TES i � P ''.`r' �nG ; SCHRO_E }ER;JEOI /I`EMA IN I I 3025 SPfZ71.0 RLAR,71P - Y FL 335.66 LICENSE NUMBER: BN7r347 EXPIRATION DATE: NOVEMBER 30- 2021 Always verify licenses online.at MyFloridaL'icense.com f Do.not alter this document in any,for,rim. This is your license.It is unlawful for anyone.other than the,licensee to use this.document 'Ron DeSantis,Governor Halsey Beshears,Secretary Florida : vpr STATE.OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE�A-DMIM!IISTRAORS &INSPECTOR THE STANDARD INSPECTORR R IN ZE'RT[RIED UNDER THE . � � PRO.VISIONS`OFiCH�APTER+-4b8,FL- A�-ST TUTES BUG ¢ Iw�� O�;,;OROFF�, M_ `IkCHAEI j ' -A 504��22NC?AEI NUE W.55 ��Igi111 SIR• 1� S�t i,."r�ri a_ Z BRA�DENTOft ; � L F34209 M LICENSENUMBER:BN,4856 ` EXPIRATION DATE: NOVEMBER 30,2021 Always verify licenses online at MyFloriclaLicense.com Do-not alter.this document in any form. ■ This is your license.It is unlawful for anyone other than the licensee to use this document: g R = Fo Ron DeSantis,Governor Halsey Beshears,Secretary dbpr� a STATE OF FLORIDA wn DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMI ;ISTRATORS & INSPECTOR � air THE STANDARD,INSPECTO ij EREIN1S CERT1-FIED UNDER THE ! ) 0 5 PROVISIONS�OF CH APTER,4'0.8,_FPRIDA STATUTES U ,Yf � WRIGH�" ORL.ANDO SEARS1 'Ya NOKOMIS� F`34275 LICENS_E_NUMBER:'BN461• ��� EXPIRATION DATE: NOVEMBER 30,2021 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license.It is unlawful for anyone other than the licensee to use this document. ■ j pF Ron Mantis Governor Halsey Beehears;Secretary ` �.. STATE OF FLORIDA .. DEPARTMENT OF BUSINESS AND`PROFESSIONAL REGULATION BUILDING CODE AD MY z _ORS &`INSPECTOR THE:STANDARD INSP>r'C'T "' f ISER > IED UNDER THE PROVISIOISCf HAPER4 CO 1 � '6 _FRI A7 TUTES i A PBEL ,.rSTEVEfNl 7 rFrA1RHE f LICB.�SENUNIBER:BlGO 6 . EXPIRATION DATE: 'NOVEMBER 30;2021' Always verify licenses onlme.at MyFLoridaLicense:com Do`notalter this document.in any form; ❑ _ :,This is your license. It is,unlawful'for anyone other than.the�licensee to use this document: . ■ Ron DeSantis,Governor Halsey Beshears,Secretary ` o bIa pr STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION i BUILDING CODE 4611AT;ORS & INSPECTOR i THE STANDARD PLa(�S1TttS CERTIFIED UNDER THE PROVIS10,08'OF'OZY TER6DA TUTESmrw I � ` sM}.i"�� ��"� �'.�.�3��-r# '� -,c»,�"'• Ram,��"zy7� �h*�-.� I IV" t r � f�; •i l`'1�£+r"FFy fib ' g 1 ,¢ QWWA � ; PQr5iFL 342� � ` i' LICE-[�15iE� �Uh�B�R: �77 EXPIRATION DATE: NOVEMBER 30,2021 7 Always verify licenses online at MyFloridaLicense.com j I Do not alter this document in any form. 's This is your license.It is unlawful for anyone other than the licensee to use this document. I i � '— Ron DeSantis,Governor Halsey Beshears,Secretary _ adb r STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE t T -T-ORS & INSPECTOR ' THE STANDARD jAIgSPEt,,q ' !t�1 GEWMIED UNDER THE PROVISIOWSVF�'C R-t ,66F `© 1}D4 ATUTES Sl km 'r rid IE�1NtY _ z f Ni ICIV LICL�IS.E�d+llJl�(B�R:B,I�03 EXPIRATION DATE: NOVEMBER 30,2021 Always verify licenses online at My Florida License.com Do not alter this document in any form. �� This is your license.It is unlawful for anyone other than the licensee to use this document. Flan DeSwgIs,G_mr imr HaKv Ez-shaam Se=m" _ ' IdU It A STATE OF FLORIDA �a DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS&INSPECTOR THE STANDARD P ANS E6AP N'ritR'HERF-IN-'IS'CFRTIF1EI)UNDER THE PROVISION5'OP_Cl,V ER 68,.FLORIbASTATI)TES ,.-W 111.-RA'ti'M.0 N D'A LL EN- DAY64t I?bI f LICENSE 14UWBEIR-OX-18 l_4.u� EXPIRATIC+NDATE:1;fOVEMBEI;30.2821 AhA%iys verily lkerases onllne at IAVRcndaLIcenwx= Do not alter this dntumen4 in any fofm, w . This.I-,your licef►se.,It is ueeL�wful for anyone other 6-tan Life the lisansce to thls document L'1e R a C paxior'-wh_cowe,= H2lscyE4!sbLar&..Scuetary _ STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS&INSPECTOR 4" THE STAN DARP INSPECLMHER EIEti:l5,Ci EZ CiFi�b 11l�Fbf R THE PROV1510N5'OF=Ci-1APTER�3b6;FLORIDA STP:TtITES �. 1x2'Bl DIG == ►YM.0ND.ALLE4 - _.�,' •r1;3�1f;S,A�h/du(�IU_ t^IAY...._.,:;;�`� , i fSAYQ�IET PU1dVT ,. FE 34fib7- �4 �LICENSE•MUWEIt:RW641 - — EXPIRATION DATE: kbVFMBER 30;2021 Ah%wo verify Ircenses online at MyRefida Liccrisp.com Do not after this document In any form. This 6 your license_It is unlawful for anyone other than tht:licensee to use this_d®cument- Tdaf • (HE Ron DeSantis,Governor Halsey Beshears,Secretary r ` f ioricia p r r STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS & INSPECTOR THE STANDARD INSPECTOR H0EIN4S_CERTIFIED UNDER THE PROVISIONS OF CHAPTER460'FL0RIDA STATUTES f CCf BLDG,'1&2;PLUM;NIECH VINES, DAVID L 4; =1825 FOX BAY DRIVE MELBOURNE FL:32934 F� LICENSE'NUMBER:BN4842y� �� EXPIRATION DATE: VEMBER 30,2021 Always verify licenses online at MyFlorida License.com _Y O • Do not alter this document in any form. This is your license.It is unlawful for anyone other than the licensee to use this document. 1. ■ --------_ .------ I pFe_E.,�i Ron DeSantis.Governor Halsey BeshearS,Secretary F�,I�,� Ifr: ncla k, STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS & INSPECTOR t THE STANDARD 1&2 FAMILY D_WEILING;-PLANS'EXAMINER,HEREIN IS CERTIFIED UNDER THE PROVISIONSOF,CHAPTER:4:68;-FLORIDA;STATUTES i VINES, bW L. 1$25.FOX BAY DRIVE MELBOURNE FL 32934 s ' LICENSE`NUvtIBER SFP167A EXPIRATION DATE: NOVEMBER 30,2021 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. ■ This is your license.It is unlawful for anyone other than the licensee to use this document. , of are STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ,r.. BUILDING CODE ADMINISTRATORS&INSPECTOR (850)487-1395 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399 Congratulations!With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers,from boxers to barbeque restaurants, r STATE OF FLORIDA DEPARTMENT dc) Frr��" ROF BUSINESS EGULATION AND PROFESSIONAL and they keep Florida's economy strong. Every day we work to improve the way we do business PX2504 ISSUED:11/16/2019 t in order to serve you better. For information about our STANDARD PLANS EXAMINER services,please log onto www.myfloridalicense.com. VINES,DAVID L There you can find more information about our divisions and the regulations that impact you,subscribe to department newsletters and learn more about the Department's initiatives. Signature LICENSED UNDER CHAPTER 468,FLORIDA STATUTES Our mission at the Department is: License Efficiently, EXPIRATION DATE: NOVEMBER 30,2021 Regulate Fairly.We constantly strive to serve you better so that you can serve your customers.Thank you for doing business in Florida,and congratulations on your new license! ------------------------------------------------------------------------ Ron DeSantis,Governor Halsey Beshears,Secretary STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS&INSPECTOR LICENSE NUMBER:PX2504 EXPIRATION DATE: NOVEMBER 30,2021 THE STANDARD PLANS EXAMINER HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 468,FLORIDA STATUTES BLDG VINES, DAVID L a o ' 1825 FOX BAY DRIVE MELBOURNE FL 32934 RM ISSUED:11/16/2019 Always verify licenses online at MyFlaridaLicense.com Do not alter this document in an form. This is your license.It is unlawful for anyone other than the licensee to use this document. e "sue STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION �4. 1 BUILDING CODE ADMINISTRATORS& INSPECTOR (850)487-1395 2601 BLAIR STONE ROAD `-, TALLAHASSEE FL 32399 Congratulations!With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers,from boxers to barbeque restaurants, STATE OF FLORIDA DEPARTMENT and they keep Florida's economy strong. OF BUSINESS AND PROFESSIONAL REGULATION Every day we work to improve the way we do business in order to serve you better. For information about our BU1409 ISSUED:11/16/2019 BUILDING CODE ADMINISTRATOR services, please log onto www.myfforidalicense.com, VINES,DAVID L There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Signature LICENSED UNDER CHAPTER 468,FLORIDA STATUTES Our mission at the Department is: License Efficiently, EXPIRATION DATE: NOVEMBER 30,2021 Regulate Fairly.We constantly strive to serve you better so that you can serve your customers.Thank you for doing business in Florida, and congratulations on your new license! ------------------------------------------------------------------------ Ron DeSantis,Governor Halsey Beshears,Secretary STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS&INSPECTOR LICENSE NUMBER:BU1409 EXPIRATION DATE: NOVEMBER 30,2021 THE BUILDING CODE ADMINISTRATOR HEREIN 15 CERTIFIED UNDER THE PROVISIONS OF CHAPTER 468,FLORIDA STATUTES [oil. VINES, DAVID L 1825 FOX BAY DRIVE MELBOURNE FL 32934 ISSUED:11/16/2019 Always verify licenses online at MyFloridaLicense.com Do not alter this document in an form. This is your license.It is unlawful for anyone other than the licensee to use this document. 1/11/2021 DBPR-HODGES,MATTHEW STERLING,Standard Inspector 12:26:46 PM 111112021 Licensee Details Licensee Information Name: HODGES, MATTHEW STERLING (Primary Name) Main Address: *Private Address* *Private Address* *Private Address* *Private Address* *Private Address* License Mailing: LicenseLocation: License Information License Type: Standard Inspector Rank: Inspector License Number: BN6730 Status: Current,Active Licensure Date: 09/18/2015 Expires: 11/30/2021 Special Qualifications Qualification Effective Building 09/18/2015 Residential 02/02/2018 Alternate Names View Related License Information View License Complaint 2601 Blair Stone Road,Tallahassee FL 32399 :: Email: Customer Contact Center,:: Customer Contact Center: 850.487,1395 The State of Florida is an AA/EEO employer.Copyright 2007-2010 State of Florida.Privacy Statement Under Florida law,email addresses are public records.If you do not want your email address released in response to a public-records request, do not send electronic mail to this entity.Instead,contact the office by phone or by traditional mail.If you have any questions,please contact 850.487.1395.*Pursuant to Section 455.275(1),Florida Statutes,effective October 1,2012,licensees licensed under Chapter 455,F.S.must provide the Department with an email address if they have one.The emails provided may be used for official communication with the licensee. However email addresses are public record.If you do not wish to supply a personal address,please provide the Department with an email address which can be made available to the public. https://www.myfloridalicense.com/LicenseDetail.asp?SID=&id=FOOEEB9B03Cl3941 E47AFABD74E34B8E 1/1 1/11/2021 DBPR-LLOYD,JAMES DEAN,Standard Inspector 12:25:55 PM 1/11/2021 Licensee Details Licensee Information Name: LLOYD, JAMES DEAN (Primary Name) Main Address: *Private Address* *Private Address* *Private Address* *Private Address* *Private Address* License Mailing: LicenseLocation: License Information License Type: Standard Inspector Rank: Inspector License Number: BN5101 Status: Current,Active Licensure Date: 09/27/2005 Expires: 11/30/2021 Special Qualifications Qualification Effective Building 09/27/2005 Alternate Names View Related License Information View License Complaint 2601 Blair Stone Road,Tallahassee FL 32399 :: Email: Customer Contact Center:: Customer Contact Center: 850.487.1395 The State of Florida is an AA/EEO employer.Copyright 2007-2010 State of Florida.Privacy.Statement Under Florida law,email addresses are public records.If you do not want your email address released in response to a public-records request, do not send electronic mail to this entity.Instead,contact the office by phone or by traditional mail.If you have any questions,please contact 850.487.1395.*Pursuant to Section 455.275(1),Florida Statutes,effective October 1,2012,licensees licensed under Chapter 455,F.S.must provide the Department with an email address if they have one.The emails provided may be used for official communication with the licensee. However email addresses are public record.If you do not wish to supply a personal address,please provide the Department with an email address which can be made available to the public. https://www.myfloridalicense.com/LicenseDetail.asp?SID=&id=FBF81 D8634A8B2D70C07FAA05E27E08C 1/1