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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
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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.
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S�UNI �1(�CE ` E�FL3�53 ..
CENSr NUMBER' A�18II5
EXP
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Ron Mantis,Governor
FBPE_
r `FLORIDA BOARD OF,
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BOARD OF P 10FE�SS G. " ENGINEERS
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WE RAUB,�J # r
LI EfSE °UMBER:PE333
EXPIRATION DATE: FEBRUARY 28;-2023 .
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aoF _ Ron DeSantis Governor Halsey Be'shears Secretary
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- . STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIO:NAL,REGULATION
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Ron Desant1s Governor Halsey Beshears secretary
Flonda
STATE OF FLORIDA
°`"E DEPARTMENT OF BUSINESS AND PROFESSIONAL.REGULATION
BUILDINGCODE ADT N VT0RS & INSPECTOR
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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
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BASS; HENRY:STEVEN
PO BOX 5221
SUN CITY CENTER, : :FL 33V
LICENSE NUMBER:PX39M
EXPIRATION DATE:SNOVEMBER 30,2021
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STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
BUILDING CODE ADMINISTRATORS& INSPECTOR
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BASS- `H EN RY STEUEN
1112 MANATEE AVENUE WEST
BMI)ENTO- "FL, 4205-
LICENSE NUMBER 6N5641
EXPIRATION DATE: NOVEMBER 30,2021
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pF Ron DeSantts Governor Halsey Beshears,Secretary
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STATE:OF FL RI O DA
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DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
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Fes' Ron DeSantis Governor
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STATE,OF FLORIDA
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Ron DeSantis,Governor Halsey Beshears,Secretary bIa
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STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
BUILDING CODE A 0� te�a S-TR, A'
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p4 A. Ron DeSantis,Governor Halsey Beshears,Secretary
Florida
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STATE OF FLORIDA
*k DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
BUILDING CODE � T Ff,m.I� rT�ORS & INSPECTOR
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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
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STATE a FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
BUILDING CODE ADtd INISTRATQRS&INSPECTOR
THE STANDARD INSPEfT6FfHER6U15.CEFITIr-It D UNDER THE
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EXPIRATION DATE: NOVEMBER3%2021
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E` Ron DeSantis,Governor Halsey Beshears,Secretary
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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-
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4825 FOX B/1Y,DRIVE'.,
MELBOURNE FL 32934
L '&'NUMBER:BN4942
EXPIRATION DATE: NOVEMBER 30,2021
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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.
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Ron DeSantis,Governor Halsey Beshears,Secretary
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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
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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.
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P,
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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