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HomeMy WebLinkAboutRevisions/CHANGE OF PRIVATE PROVIDER OFFICE USE ONLY: DATE FILED: �. - O `-' O / PERMIT# REVISION FEE: RECEIPT# ass �e d. PLANNING& DEVELOPMENT SERVICES BUILDING&CODE REGULATION DIVISION 2300 VIRGINIA AVENUE RECEIVED FORT PIERCE,FL 34982.5652 (772)462-1553 FEB 2 5 20Z, APPLICATION FOR BUILDING PERMIT REVISIONS p�rmitting gr�artment PROJECT INFORMATION 9t; 6p@ja county LOCATION/SITE ADDRESS: 44� DETAILED DESCRIPTION OF PROJECT REVISIONS: /I 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 OWNER/BUILDER 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 Revised 06130117 WEINTRAUB INSPECTIONS&FORENSIC,INC. Notice to Building Official of Use of Private Provider Project Name: _ ( L'' P�11��1�1�J (,(� FL Z, Parcel Tax ID: ( 3 Q 1 - Ce IQ— Services to be provided: Plans Review_ Inspections[Building Pool Other 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. 1 a Qo the fee owner,afti I ave entered'hilo a 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:81346$8026 Email Address(Optional):jwolfersberger@weintraubinspections.com Florida License,Registration or Certificate:Professional Engineer 30033 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 bold 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 i I lifi WEINTRAUB l 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 WS1 fiL ZL,C Print Corporation Name Print Partnership Name By; By: (signature) signature) (signature) Print Print p Print Name: Name•% o / Name: Address: Its: r' r Its: Address: Address: Telephone 0"J,0 AI .9 eT te,rig - No.: -/VD.rCf'OJI) 011,36017� Tel ho�}e /t� Telephone No. /' a��0, 6( 9C, No.- Please use appropriat block. STATE OF I � i COUNTY OF ( 1 Individual Corporation �J Partnership Before me,this day of Befo a me,this —` day of Before me,this day ,20_1 personally 20 J of ,20_,personally appeared personally appeared appeared who executed the foregoing instrument, of partner/agent on behalf of j and acknowledged before me that same ,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. l Personally kno ,or Produced identification Type of identification produced -CD A�— Signature of Notary Print Name Notary Public:NOTARY STAI\1P BELOW =._ My commission expires; p 3868 Sun City Center Blvd.Sun 2 of 2 Phone: 813-633-8000 City 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 Tele hone Number: 321-474-1459 Fax Number: 813-464-8026 License number PE 300033 Company: Weintraub Engineering 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 Building Inspections Performed: Insurance policy GL 10006 number I r 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 ,a►`�o�® CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDDIYYYY) 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 o E:t: (407)843-1120 FAX 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: Bridgefield 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 NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR 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 ADULSUBRI POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER MMIDDIYM MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE �OCCUR PREMISES Ea occurrence S 100,000 MED EXP(Any one person) S 10,000 A GL100063261 11/15/2020 11/15/2021 PERSONAL&ADV INJURY S 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE S 2,000,000 2'000'0POLICY�PRO 00 OTHER: Employee Benefits $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 Ea accident X ANYAUTO BODILY INJURY(Per person) S A OWNED SCHEDULED CA100063259 11/15/2020 11/15/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED Ix NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Drive other car 5 X UMBRELLALIAB X OCCUR EACH OCCURRENCE S 5,000,000 A EXCESS LIAR CLAIMS-MADE UMB100063260 11/15/2020 11/15/2021 AGGREGATE 5 5,000,000 DED I X1 RETENTION$ 10,000 S WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY Y/N B ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? NIA 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 S Professional Liability Limit Per Claim $2,000,000 C MCH591943348 10/01/2020 10/01/2021 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be 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 i 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 , XA,V UN I IVV. 2020 -2021 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT EXPIRES SEPTEMBER 30,2021 271253 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 L SUN CITY CTR,FLR 33573 2 0 0 s r5` m —M I �,�?, 0-WEINTRAUB INSPECTIONS&FORENSIC, INC. NAME 3868 SUN CITY CENTER BLVD MAILING SUN CITY CENTER, FL 33573 ADDRESS Paid 19-0-407771 07/24/2020 54.00 BUSINESS TAX RECEIPT DOUG BELDEN,TAX COLLECTOR HAS HEREBY PAID A PRNILEGE TAX TO ENGAGE 813.6355200 IN BUSINESS,PROFESSION,OR OCCUPATION SPECIFIED HEREON THIS BECOMES A TAX'RECEIPT WHEN VALIDATED. q pF-Tim ST9pty ,Ron DeSantis Governor Halsey Beshears Secretary - -STATE OF.FLORIDA DEPARTMENT OF BUSINESSMAN. D=P OFESSIONAL REGULATION BOARD y F, PROFENAE CINEERS-" THE ENGINEERINGBl�1SFNESS��#EREIN�;tS<AUTH,Qf31ZED UNDER THE - 'ENGINEER :ry - Of GH%APTER"47�FLOI�lDA�STATUTES 2 WEINTRAUBINSP�CT ON-SY& ORENSIC INC. 3868l1NzG =4�CEIL3ER BL=-D' S�UNI �1(�CE ` E�FL3�53 .. CENSr NUMBER' A�18II5 EXP P - . IRATION D dJlkRY2 '� -_ E F B 8 2021 E Always yerifiylicenses 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 Ron Mantis,Governor FBPE_ r `FLORIDA BOARD OF, -. - PROFESSIONAL ENGINEERS . •r, STATE OF FLORIDA: BOARD OF P 10FE�SS G. " ENGINEERS THE�PROFESSIO�yAL EN I €E I�K S�LIC-LASED UNDER THE PROVISIONS O CNA TEaRt 41;�FLOR:DAFT TUTES WE RAUB,�J # r LI EfSE °UMBER:PE333 EXPIRATION DATE: FEBRUARY 28;-2023 . Always verifyaicenses onlineat MyFloridaL'icense.com Do not alter,this document m any form: �� This is your,license.at is,unlawful for anyone,ofher than.the licensee to use this document p4 - Ron DeSantls Governor FUE 'FLORIDA BOARD OF' STATEOF FLORIDA PROFESSIONAL:ENGINEERS •"COD W£ • ' BOARD OF PROFESSION L EN.GINEERS NDERTHEE THE PROF C NSD U PROVISIONSC�FlCI=CAPTER CORI,DA STATUTES . . RA � �CH tN� Nam' j N�M'A;�. s. A f` D�RA , t S A 5095 r•UT r, u(PTON CI CL 71 r,N -T�AI�:PA ,�F�L�336�47 LICENSE'N�UI BER�73'119 . EXPIRATION DATE: FEBRUARY 2k2023 Always verify:licenses online.at"MyFloridaLicense:com Do not alter this document in any form. doc This is your,license.It is unlawful for anyone other,than the•licensee to use this ument- 0 .Ron DeSantis,Governor Halsey Beshears,Secretary. _ o Florida •. .:"STATE OF FLORIDA .. . COD NB } ._• .. :. .' .. `• . ._ .- . DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION :. BUILDING CODErSS21pEk3,6" MIMI ADM ; TRAXORS & INSPECTOR THE STANDARD INR ISCE-RT[DIED UNDER THE PR FHrAPTER±Y4,E�$FLORIDAtSTATUTES 1�&�2" WCOEFER�J=01 E 1, VIM -- LV _AVEUE E ' R` I M;�BAY 7FF32,90171 22�3 F , LICE IS NUMBER:-B,,4874: EXPIRATION DATE: NOVEMBER30;: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 ■ aoF _ Ron DeSantis Governor Halsey Be'shears Secretary Flonda - . STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIO:NAL,REGULATION -BUILDING,CODE bM-1�ISTR'At RS & INSPECTOR THE STANDARD 15RE 6 it 1�S CR`�F IED'UNDER THE;. PROVISIO`S�CJ�F CIA TER��l�8;FOR1 A+STATUTES B ®G ; 'MC I Nlow _ CUEE�= F 34761 - f - ., LI E SENUABER: 1 3 EXPIRATION;DATE=;`NOUEMBER'30,'2021 Always verify licenses onhne,k MyFloridaLicense com s Do not alter this document m anyform, • _ This is your license It is unlawful for_anyoneJother than the-licensee to use this document Ron Desant1s Governor Halsey Beshears secretary Flonda STATE OF FLORIDA °`"E DEPARTMENT OF BUSINESS AND PROFESSIONAL.REGULATION BUILDINGCODE ADT N VT0RS & INSPECTOR THE STANDARp PLA TN $ TIF.IED UNDER THE PROVISIQ S� F CkAP7sER`4S, FCrOR DAFT',TUTES LICfSNUh1BER��P -� 2 EXPIRATION DATE. NOVEMBER 30;`2021 Always verify licenses online,at MyElondaCicense com Do not alter this document in anyform. �• This is.your license It is unlawful for.anyone other than the licensee to use this document r pF c Ron DeSantis,Governor Halsey Beshears,secretary dbpr a STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS & INSPECTOR THE STANDARD PLANS?EXAMINER'HEREIN IS`,CERTIFIED UNDER THE PROVISIONSOF:CHAPTER 468;:FLORIDA STATUTES _ BLDG _ BASS; HENRY:STEVEN PO BOX 5221 SUN CITY CENTER, : :FL 33V LICENSE NUMBER:PX39M EXPIRATION DATE:SNOVEMBER 30,2021 Always verify licenses online at MyFloridaLicense.com ❑M 91 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. p = Ron DeSantis,Governor Halsey Beshears,Secretary Florida - dop STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS& INSPECTOR THE STANDARD INSPECTOR HEREIN_IS,CERTIFIED UNDER THE PROVISIONS'OF CHAPTER;468,,FLORIDA STATUTES BLDG,1&2; BASS- `H EN RY STEUEN 1112 MANATEE AVENUE WEST BMI)ENTO- "FL, 4205- LICENSE NUMBER 6N5641 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. pF Ron DeSantts Governor Halsey Beshears,Secretary _ Florida _s z ..STATE OF FLORIDA .' WE DEPARTMENT•OF BUSINESS AND-PROFESSIONAL REGULATION BUILDING CODE AD.M114I5TRATORS & INSPECTOR THESTANDARDJINSPE OR�HEREji-t1 z-9RaTIFIED'UNDERTHE' PROVISIONS`OF�'CHAPTER+46 .FLORIDA STATUTES BQ M C=�4 i fE FE,E 'f: DE`IV'Al� E t� S2a2I m1PRES�DENTIAL STD = fi BEEF`EftFs33584 . LICENSE NUMBER: B 465 EXPIRATION DATE: NOVEMBER A 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. FRIY. - - p4 Ron DeSantis,Governor �o Halsey Beshears,Secretary. Florida pr . STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION . BUILDING CODE D.MINI=STRATORS'& INSPECTOR THE STANDARD•NSPECTOR�H}'`' :EI� IS CE-RT TIED UNDER THE PROVISIONS40F GI�APTER.`468_=FLORI'DAST TUTES- t r ,. E- 1 „AAo rE� y fi�F9�t_ ` BjALD�IN ERC I-GSfiEPHENa (� 5052 OUERTO DRR- t L 51 k't KE1�/PQ:RT�RICHEY FL 34652 LICEI(SE NUMBEIR— 7561: EXPIRATION DATE: NOVEMBER'30,2021 Always verify licenses online.at MyFloridaLicense.com ; ti 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. 0 . pF 9pA Ron-DeSantis,Governor Halsey Beehears,Secretary. �,� Florida STATE OF FLORIDA` WE DEPARTMENT OF BUSINESS AND PROFE5510NAL REGULATION BUILDING CODE ADIVIIF'1411ST .'ATORS'& IN THE STANDARD I' SPEGTORtH REtNrISCERTI�,,IED"UNDER THE PROVISIONS ':PTER+`468rFLORtpAST.TUTES �—� .ter•,,� ,a ,� .. � 1, fs, =LM F�1-DANIVA, 1450ODD AVE . r _b +t Ili I I , _ ®RLANDO � 3282.2: LICENtSE'NUMBER:B �3`84 EXPIRATION DATE: NOVEMBER 30;2021 Always verify licenses online at MyFloriclal_icense.corri Do.not alter,this document in any form.. �� This is your license.It is unlawful for anyone,otherthan the licensee to use this document.- p4 Ron DeSantis,Governor - o . Halsey Beshears,secretary. Florida . 'STATE OF FLORIDA` WE q DEPARTMENT OF BUSINESS AND PROFESSIONAL-REGULATION BUILDING CODE:ADMI MQS R'AzTORS & INSPECTOR , � �,� THE STANDARD 1NSPE TORxHEIN�IS CERTl<IED UNDER THE PROVISIO.NS�OF G—�=f�A�TE�R�,46$;`F13ORIDA=STATUTES--= SCHR�OEDER1,bJE OM ARTIN s 3025 PRING.IAMMOCK�DR r idt, - PLANT'CtTiY FL33566 LICENSE NUMBER: BN734T -EXPIRATION DATE: NOVEMBER 30,2021 Always verify,licenses online at MyFloridaLicense.com ❑■ 0 Do not alter.this document in a'ny form... This is your license.It is unlawful for anyone.-other than the licensee to use this document. A Ron DeSantis Governor' Halsey Beehears;Secretary b a ter. STATE:OF FL RI O DA D- W£ DEPA .RT,MENT OF-BUSINESS- "AND:PROFE S NA : - .S 10 L REGULATIONS BUILDING CODE..ADh#(NISTRAtTORS & INSPECTOR THE STANDARD NS E• OR "EMI � 6� l D UNDER THE', " - . p� PROVISIO.. S}C3F GFiAhTERY4' $;�F�OR{'DAFT TUTES - _ R . I'CH �#E=L 450� �- S 22N®A\fENU'E WES BB4D �wT. FL 34209 ► 'dE LIISF�+IUMBER:BN48`56 EXPIRATION DATE:,NOVEMBE100j'2021 Always yerify licenses online,at MyFloridaLicense:com Do,not alter this document m anyform... . ■ Tlis is your license..It is unlawful for anyone other_than the licensee to use this.document: { Ron DeSantis,Governor Halsey Beshears,Secretary o Florida dopr! STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS & INSPECTOR THE STANDARD,;INSPECTORr`HEREIN7S CE0i�_IED UNDER THE PROVISIONSOF�CHAP�TER 468,FLORI'QA'S,TATUTES , s� t. W 4 r3 �5 vt �r 26 A. WR,IGHT iF,ORLAN DO"SEARSry 4r O DOLPHIN SHORES CIR LI -El"' R EXPIRATION DATE:-N- EMBER 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. 1 Fes' Ron DeSantis Governor o A HalseyBeshears,Secretary. Florida. • .� D . STATE,OF FLORIDA � , DEPARTMENT OF BUSINESS.ANUPROFESSIONAL REGULATION BUILDING CODE ADM f IISTR;! ORS`& INSPECTOR THE STANDARD INSPEC,:ORH'E S CE=R�TI;IED UNDER THE - PROVISIONS OF CHAPTE 468.,FC0R DA,zSTATUTES �-... caMPIBEL_L;��STVEN 3 7 ,, F�AI�RNEVENfS�T N'E T` Y»x , 4tji jti NW MLM,„. rT i u `r LICENrSE N`"iJMBER:BN6056 EXPIRATION DATE; NOVEMBER'30,2021. Always verify licenses online at MyFloridaLicense.com NMI M Do riot alter this document in any form:, ■ This is your license.It is unlawful for anyone other than.the licensee to use this.document. 4 Ron DeSantis,Governor Halsey Beshears,Secretary bIa pr : STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE A 0� te�a S-TR, A' ORS & INSPECTOR Z,"� ETHE STANDARD PLANS EiRTIFIED UNDER THE PROVISI0I0FFTEIDAATUTES r3i r aartr-- r 3• uy, +� Spa C s { �-•F Xv� 'E Y�am �C "i -4 r f 3422AR §A , Ar y..-. T^Tom, Lift-M UN ER 3 0y7 EXPIRATION DATE:NOVEMBER 30,2021 Always verify licenses online at MyFloridaLicense.com �0 Do not alter this document in any form: i ! This is your license.It is unlawful for anyone other than the licensee to use this document. I I ' p4 A. Ron DeSantis,Governor Halsey Beshears,Secretary Florida prt STATE OF FLORIDA *k DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE � T Ff,m.I� rT�ORS & INSPECTOR THE STANDARD,14S ,itT-,�R G-E I E D UNDER THE l PROVISIOa S`G.FC RI�T€R1 b FLO 1D/�STATUTES Wn 'Sk ,rppY'Y t 0 t '�e,.,rz L } ti 64 f s AM, CY,MT F.�.y At E ..'jL '^9.+asr�"' Y 4r.�"E r 1 �_'•�'Lr'—, - 4 �FQ7f�j'F1N/•tY � —yt , Y �' n�a LTET�"0� � 3422 . D q mPJv�� to xi Ny fF9_ LICf�ISE„��IIJIK�Bdt:B�fbB�3 EXPIRATION DATE:O EMBER 30,2021 Always verify licenses online at MyFloridaLicense.com I 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. i FL�n Qzrt.171s.iCiovCh'M�r H±rl:ey L'�°s&xras Se[ntb� y STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMf[VISTRATORS&INSPECTOR THE STANDARD PLANS EXAMIhIER'FIERE-W!S'CER"TIF1EE)UNDER THE I PROVISIONS d7I°_GIHAPTeR 466;FLORiBpa.ST'ATUTES A.- BLDG IIFI-L RA,YMONU aLLEN Ny BAYCINET PCJ1i�LT F.L3 5r7 IXPIR AT]ON DATE:a NOVEMBER 30.2021 r�� Mwiiys ircriiy I'itenscs ontlne at MyRdejdaLicense.ewn { n-1E�;^^�� fp a Do not alter this document in any form. This. 5 your license"It ls.unlWiful for anyone other than tfec iicensce to use IN&document. Ren deS7ilji3,Go rr w Hakey 8'stx am Secretary' 4t r F du STATE a FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADtd INISTRATQRS&INSPECTOR THE STANDARD INSPEfT6FfHER6U15.CEFITIr-It D UNDER THE FROV151QfV5�OF_-CE-�AP�R��F68 FLl7R1DA�STATUTES WU,, R/�tY 4 NUALLEN �3014,SAWMILLWAY -_ = 'BAYONl;T PQ tdT';D Ft 34bb7'= UCEN k'N':UMBER 814 e81_ EXPIRATION DATE: NOVEMBER3%2021 Ahacrys verify licenses online at MyRoridaUmnse.com ' - Do not miter this document in.any Form. This Es your license it is unls�vful for anyone other ftn the licensee to use this.docuinent. �E E` Ron DeSantis,Governor Halsey Beshears,Secretary Loo­­r •v° � 9�� db c STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS & INSPECTOR THE STANDARD 1NSPLCTOR'HEREIN;15 CERTIFIED UNDER THE PROVISIONS OF CHAPTER 46t:." Oki- EL STATUTES CCI,BLDG;.1&2,•;RLUM.MECH, 1 + VINES,`DAVID L 4825 FOX B/1Y,DRIVE'., MELBOURNE FL 32934 L '&'NUMBER:BN4942 EXPIRATION DATE: NOVEMBER 30,2021 i Always verify licenses online at MyFlorida License.com NJ. R1 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. i ' v � ' Ron DeSantis,Governor Halsey Beshears,Secretary dk) STATE OF FLORIDA DEPARTMENTOF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS & INSPECTOR THE STANDARD 1&2 FAMILY[?.YVELLING-"PL-ANS b(A-MINER'HEREIN 15 CERTIFIED UNDER THE PROVISIONS-Of,, T '1825,FOX,,BAY DRIVE 41 � | 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. ` . : . .� — _-_-- _--_ ----_ — _- ' � r a STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS&INSPECTOR (850)487-1395 ' Pa 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399 cQb a-E I 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, a STATE OF FLORIDA DEPARTMENT and they keep Florida's economy strong. 5OF BUSINESS AND PROFESSIONAL dbW- REGULATION t Every day we work to improve the way we do business in order to serve you better. For information about our PX2504 ISSUED;11/16/2019 STANDARD PLANS EXAMINER S services,please log onto www.myfloridalicense.com. VINES,DAVID L i 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 0 . 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. C P, �w j13E 3T' STATE OF FLORIDA 3 s•_• DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION (Q " BUILDING CODE ADMINISTRATORS& INSPECTOR (850)487-1395 5 -ill �� 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399 We ems. 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. dbbr OF BUSINESS AND PROFESSIONAL REGULATION Every day we work to improve the way we do business BU1409 ISSUED:11/16/2019 in order to serve you better. For information about our BUILDING CODE ADMINISTRATOR 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. g Si nature LICENSED UNDER CHAPTER 468,FLORIDA STATUTES Our mission at the Department is: License Efficiently, EXPIRATION DATE: NOVEMBER 30,2021 i 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 I LICENSE NUMBER: BU1409 EXPIRATION DATE: NOVEMBER 30,2021 THE BUILDING CODE ADMINISTRATOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 468,FLORIDA STATUTES M�r _ VINES, DAVID L 1825 FOX BAY DRIVE MELBOURNE FL32934 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: License Location: 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=F00EEB9B03C13941 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: License Location: License Information License Type: Standard Inspector Rank: Inspector License Number: BN5101 Status: Cu rrent,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.myforidalicense.com/LicenseDetail.asp?SID=&id=FBF8i D8634A8B2D7OCO7FAA05E27EO8C 1/1