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HomeMy WebLinkAboutRevisions/CHANGE OF PRIVATE PROVIDER OFFICE USE ONLY: DATE FILED: `off/ PERMIT# a 1 I ()3 3 (V REVISION FEE: � ��_ RECEIPT# PLANNING&DEVELOPMENT SERVICES BUILDING&CODE REGULATION DIVISION 2300 VIRGINIA AVENUE FORT PIERCE,FL 34982.5652 (772)462.1553 RScetyEa APPLICATION FOR BUILDING PERMIT REVISIONS FEB PROJECT INFORMATION LOCATION/SITE r�Lu ie C nur;,r ent ADDRESS: 7pn �; P( L)rrnQSCe LaN) DETAILED DESCRIPTION OF PROJECT REVISIONS: 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 06/30/17 f � I TRA WE B N U INSPECTIONS&FORENSIC,INC. Notice to Building Official of Use of Private Provider Project Name: IA-)O' -1 zFL. LLl--,- oo (��V`a- L_L,Pq,-,o� Parcel Tax ID: 130) Co.3, -Don , Services to be provided: Plans Review_ Inspection _[Buildin 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 YY1 Cry- 'Do � the fee owner,affirm I have enterefl4rito a contract Wth 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):jwolfersberger(.dweintraubinspections.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 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.N 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 k�)�l-+ 'r-L_LL_J P ' rporatiosl�l a Print Partnership Name By: By: (signature) (signature) (signature) Print Print Print Name: Name%1'1 Name: Address: Its VAy its: Address: Address: Telephone 322/ )A rj I No.: NCrL'-YDVvi Ge I a�ors`l j Tel�,�h,one Telephone Nc( I)Q K)'(1IDo2� No.: Please use appropriate notary block. STATE OF COUNTY OF Y��'y_�7CI Individual Corporation Partnership Before me,this day of BVeVis day o Before me,this day 20�personally ,20 of ,20_,personally appeared personally appeared appeared who executed the foregoing instrument, of -partner/agent on behalf of 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. i i Personally known or Produced identification Type of identification produced j Signature of Notary Print Name i Notary Public:NOTARY STAMP BELOW My commission expires: MVtMV pUMp Saw of Fronde 5 0- +' MY CoffwrdumKM 020010 ! 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 PROVIDED 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 Enciineering 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 2-6� r Signed rovider PROVIDER NO.2 Primaty 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 ACC CERTIFICATE OF LIABILITY INSURANCE DAT11(/30/2020 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 terns 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 PnH.ON. Exit (407)843-1120 FA(AICX, No: (407)943-5772 801 N Orange Avenue E-MAIL ADDRESS: suite 510 INSURER(S)AFFORDING COVERAGE NAIC 0 Orlando FL 32801 INSURERA: FCCI Insurance Company 10178 INSURED INSURERB: 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 CERTIFYTHATTHE 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 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 AUDL SUBRI POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVO POLICYNUMBER MMIDDIYYYY MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s 1,000,OOD AG o CLAIMS-MADE NOCCUR PREMISES Ea occurrence S 100,000 MED EXP(Any one person) S 10,000 A Y Y GL 100063261 11/15/2020 11/15/2021 PERSONAL&ADV INJURY s 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 FIPOLICY ®JECOT- LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: Employee Benefits S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 Ea accident Ix ANY AUTO BODILY INJURY(Per person) S AOWNED SCHEDULED Y Y CA 100063259 11/15/2020 11/15/2021 BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY Per accident H I I Drive other tar $ X UMBRELLA LIAR I X OCCUR EACH OCCURRENCE S 5,000,000 A EXCESS LIAR CLAIM.-MADE UMB100063260 11/15/2020 11/15/2021 AGGREGATE S 5,000.000 . DED I X1 RETENTION S 101000 S WORKERS COMPENSATION X1 PER ERH- AND EMPLOYERS'LIABILITYSTATUTE ANY PROPRIETORIPARTNERIEXECUTIVE YIN 1,000,000 B OFFICER/MEMBER EXCLUDED? N N/A Y 0196-51752 10/15/2020 10/15/2021 E.L.EACH ACCIDENT S (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 Y MCH591943348 10/01/2020 10/01/2021 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached it 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 St Lucre County,Building Division ACCORDANCE WITH THE POLICY PROVISIONS. 2300 Virginia Avenue AUTHORIZED REPRESENTATIVE Fort Pierce FL 34982 /iQ ©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 t 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 HI.I.VtIIV I IVV. 2020 -2021 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT EXPIRES SEPTEMBER 30,2021 271253 O CC.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. SUN CITY CTRBL SUN 33 J SUN CITY CTR,FL 33573 &26 2 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 PRIVILEGE TAX TO ENGAGE 813.6355200 ' IN BUSINESS,PROFESSION,OR OCCUPATION SPECIFIED HEREON THIS BECOMES A TAX RECEIPT WHEN VALIDATED. q t p4 _ Ron DeSantis,Governor, ' Halsey Beshears,Secretary Florida STATE OF FLORIDA DEPARTMENT OF BUSINESS_,Aj---PRO.FESSIONAL REGULATION BOARD OF�PR 1FE5S ONAL'"ENGINEERS , S f ERREIN1SHYD. NDER THETHE ENGINEERING,BISINESTIYTA , M `ORDASTATTSPROVISIONSFEA U WEINTRA:UiBINpSyPECTI�NS;&FORENSIC INC. fff4� fd�liljPj�e-yy�q�a...,�'.�.r—=���1 3868�SU,NxCITY CENTERnBL/D.— KYrAt Iit1A{ g-lrer 1• �kT S I tWEKP,FL3UNC 3573= .°LICENSES UMBER:CA283,,53 RFONDA EEXPIRAT � WAR 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. 0 . p4 Ron DeSantls Governor PROF SISIONAUEENGINEEERS, STATE OF FLORIDA i 1p r'OD:WE - `BOARD OF PROFESS{tONAL:ENGINEERS, -. UE THE PROFESSIONA"C EN 1_, Ef R PUEL SED UNDER THE , b 4, PROVISION•S6FAP I'E<Ri4 �F�0121'U�4ST.TUTES Ij E : =�BU•ERIY %laR 38 815111WGIF NCENTER L _ UN' E. F` E FL 335�7 LICENS NUMRR PE30 33: EXPIRATION`DATE :FEBRUARY 28,:2023 Always verify licenses online:at,MyFloridabcense.com Do,not alter, this document in anyfor ' �� _- This is your license-It is unlawful•for-anyone:other than the licensee to"use this docurnbn Ron Desantis,Governor ic : F_BPE FLORIDA BOARD OF - PROFESSIONAL:ENGINEERS S � TATE OF•FLORIDA BOARD-OF P OFBSSIONAL•ENGINEERS THE PROFESSIONAL EN.GI EERH RETMISIFIICENS,ED UNDER THE PROVISIO.NS�OFHA�P7^—F1 RDA�STATUTES". O5'9 SOUTHMPTQN CI CLE .LICE SE�NUMBER:PE7,3119 EXPIRATION'DATE:`FEBRUARY 28,2023 Always yerify.!itenses online at MyFlorid. icense:com Do not alter this.document.in any form., -� Thk-is your license.It is unlawful-for anyone ofher than'the,licensee to use this document:: 4 Ron DeSantis,Governor Halsey Beshears,Secretary. Florida pr STATE.OF FLORIDA`: �D DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTR`ATORS`& INSPECTOR THE.STANDARD NSaPEC,TQ.R HERE�1S-CERT,fIED UNDER THE PROVISIO,NS�OF#CHAPTER�`4' 18, FC'ORP, A�STATUTES ft V1/OE TE, 131E,RGER J_ON E ,� 240,V�EL�VET�AVENUE NE-—= - - • J . . �e'PAL�M�B�A'Y F 32907-2�2�33 • LICE:S UI�!TBER:BN.48`74' EXPIRATION.DATE: NOVEMBER`30,2021 Always verify licenses online.at MyFloridaLicense.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. p k Ron DeSantis,Governor, Halsey Beshears,Secretary o� Florida - - ,r. STATE OF,FLORIDA';, DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION.. BUILDING CODE ADMINI TRAITORS&INSPECTOR THE STANDARD N*s_nCT3OR H'E EI_ JSCERT( IED UNDER. PROVISIONS OF•GM,APTER - -- LORI'� �4 TATUTES b8 F S y-� 9 B,LDG P f - R �� - A r l�MC III NEI' B-QB _=Y�=J - 1�3�CLO,WS®N C 1OUR�.T A p6 , �OCQEE FL 34761 WN LICENSE`NUMBER:13yN .83 EXPIRATION DATE:"NOVEMBEW30,2021 Always verify:licenses online-at`MyFlorida[icense.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 DeSanbs Governor Halsey Beshearsf Secretary Flonda, :\;STATE OF FLORIDA DE.PARTM,ENT:OF BUSINESS AND PROFESSIONAL:REGULATI,ON BUILDING-CODE DMIN`STiA�TORS& INSPECTOR THE STANDARD P,L�A ' E . rvf I l! �TIFIED UNDER THE PRQVISIONSOF' T ,�{CIAP�ER1z8-F�ORIDASTATUTES _ B''Dd _ n a _f _ 1 1 4^ s B: Y.M� N N�EY OBE C O: SOU 3130O�WS C Ri L .' 4 Ql COEE �FL 34764 �S 1- LICE •j ER:.P 292. I .E NUM B EXPIRATION DATE: NOVEMBER'30;2021 • Always verify:licenses online;at MyFl,oridaL'icensexom Do:,not alter.this document in any form. . �• This is.your license_.It is"unlawful for anyone other than'the,licensee to use tkis document ❑� r , p4 Ron DeSantis,Governor Halsey Beshears,Secretary sp Florida I r v 8b ,h l STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS & INSPECTOR THE STANDARD PLANS:EXAMINER;HEREIN-IS CERTIFIED UNDER THE PROVISIONS QF.CHAPTER 468_ifLORIDA STATUTES 'BLDG` - BASS, HENRY:-STEVEN Pa BOX':5221 . 'SUN CITY CENTER;,.,FL,33571 LICENSE NUMBER:PX20M EXPIRATION DATE: NOVEMBER 30,2021 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. OThis is your license.It is unlawful for anyone other than the licensee to use this document. r p4 -dsl Ron DeSantis,Governor Halsey y Beshears,Secretary Florida U o r •�,���.�• 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; HENRY STEVEN; 11,12 MANATEE AVENUE:WEST ' '-BRADENTON FL 34205_; = b LICENSE NUMBER:BN5641 EXPIRATION DATE: NOVEMBER 30,2021 Always verify licenses online at MyFloridaLlcense.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. pF - Ron DeSantis,Governor Halsey Beshears,Secretary. d-blar. < .. STATE OF,-FLORIDA'. - DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE AD.M IISTRATORS & INSPECTOR THE STANDARD INSP'ECTO.R HER NIE CIS GERTCFI "D UNDER THE ,ti v:., ;s is __ * 9. 1 PRQVISIONSOF<CHAPTER+468;.FL`ORFDA STATUTES: k f === bLDG jT�R fIII1''Iz5vJ,•? P?� MCAFkEE,,'ER1DWA�YNE S j5227ilo JPRESIDENTIAL STr SEFF 'ER `R,33584; � _ �atu LICE4SE`NLIW BNr7 65 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. -Ron DeSantis,Governor Halsey Beshears,Secretary . o� Florida �. STATE OF FLORIDA WE DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINfST1tATORS & INSPECTOR TFiE STANDARD NSPECT®Rx 'EREI_I CERTIFIED UNDER.THE I G6 6" ! R- PROUISIO.NS F CHA�PT R 4 `== �ORI� A STATUTE� O, Fs E, $_F .� �D S .�'-tee-,;:;, 9 �4( B�ALD�IEN�GER� Gp�l41��ST�P .: 5 V, 2f D' NIEWYFORT°RICHEY FL 3.4652 LICE.SC�NUMBER:B,N�7.561 -EXPIRATION DATE: NOVEMBER,30,2021 Always verify licenses online.at,MyFlondaLicense.com 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. 1 Ron DeSanUs Governor Halsey Beshears Secretary FlOnda STATE OF FLORIDA DEPARTMENT OF BUSINESS AND P'ROFESSIONAL'REGULATION BUILDING CODE ADMIiS'1 A ORS &INSPECTOR THE STANDARD c OR WEt -S CERgT FIED UNDER THE . .-PROVISIONS�3E -�lAPTE `4'�B;�FOR'EA�ST�ATUTES - — -✓ SALMI O r ��A1�t 6 S07 .r DD FI- A -. NDO LICE,SENUMBER:BN73$4 . EXPIRATION,DATE NOVEMBER`30;2021 Always verify licenses onlme,at`MyFlondaLicensecom Do not-alter this document m any'form. - �� This is.your license It is unlaviiful for anyone;other than'the licensee to use this document j. Ron DeSantis Governor, Halsey Beehears Secretary �- oA Flonda _ STATE OF FLORIDA DEPARTMENT_OF BU„SI.NESS AND PROFESSIONAL'REGU-LATIYON BUILDING.CODE`ADNttl�l'ISTi AXORS& INSPECTOR THE STANDARD INSMFMA-�' fSCEIEDUNDER THE .PROVISfOI S dF �P ER�-4--.rF1 1! A�STATUTES LD`G,� E S P H`RO L ' ' R,�JE 'M" - RTI N 3025 , `Y Pc�MOCKD _ N3T C1--F • 'L 3356- LICE SE-aUIvIBER EXPIRATION;DATE: NOVEMBER 30,2021 .Always verifylicenses online..at MyFI ridaCicense:com D&,not alter this,document in any,form., ;This isyour license It`is unlawful for anyone,other than the licensee to use this;document p4 TE Ron DeSantis,Governor Halsey Beshears,Secretary blar STATE OF FLORIDA' �DWTI DEPARTMENT.OF BUSINESS AND PROFESSIONAL.REGULATION BUILDING CODE ADMINISTRATORS & INSPECTOR THE STANDARDr] SPEC-7:6r El�',REINJS CER-,T��IFIIED UNDER THE PROVISIO ,S-OF�CHsAPTER�Y468;:FLORI�DA-STA N TUTES PTO ,,�1 �;;�ROF.E MICHAEL �e . 04122ND�A�/ENUE WElST G <,: BRADENTON� ;' a-L 34209�_' "tic, r� 3 l� LICEWf 11 NUM'SER:BN41�§6 -EXPIRATION DATE: NOVEMBER 30,2021 . Always verify.licenses online.at MyFloridaLicense.com Do not alter,this document in any form. F ■ This is your license. It is unlawful for anyone other than the,licensee to use this document.- Ron DeSantis,Governor Halsey Beshears,Secretary _ - o Florida ROW ; , STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADM.1,1�ISTRATORS & INSPECTOR THE STANDARD,:IIJSPECTORHREIN IS CERTIFIED UNDER THE PROVISIONS-"OF CHAPTER�468,-FLORIQA STATUTES BLDG h "W ofli�T,�OR LAND . SEARS j <; 3 p � � .44 3 ��!�320sbOLPFi:IN SHORES�CIR NOKOM(S 4275 ^ LICENSE NUMBER:B. 4 1 IXPIRATION DATE:a NO M ER 30,2021 Always verify licenses online at MyFloridaLicense.com 0� 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 pFAo Ron DeSantis,Governor Halsey Beshears,Secretary. db'or. STATE OF FLORIDA VWME DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS & INSPECTOR THE STANDARD INSFECLOR�HERtEIN'ISLCERTI_-I�ED UNDER THE - PROVISIO, 'F;CHA15TER.468,_FLORIDA=STATUTES ,F4Z iy�. ELL P- } CAM P`B_E�LLf STVEIM, 0797��F/�IRk1AAVEN�ST NEB= ` PAAI FL;32907 LICE~SEfiUMSER:BNG06 EXPIRATION DATE: NOVEMBER 30;2021 Always verify licenses online at MyFloridaLicense.com T - 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 pfr o. Ron DeSantis,Governor Halsey Beshears,Secretary � FI rida dopr , : }r STATE OF FLORIDA r� DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION - i BUILDING CODE A9� TORS & INSPECTOR THE STANDARD 131-405 F q�+ I � �- Q7ERTIFIED UNDER THE -A PROVISI0I4�S-002-1 MI; UTES Inn eh I.' v�y yy r � - r h 1-4 LIl ` M— f $C�ft: 3777 EXPIRATION DATE: NOVEMBER 30,202-1 ' Always verify licenses online at MyFloridaUcense.com Do not alter this document in any form. I � f This is your license.It is unlawful for anyone other than the licensee to use this document. I i i Ron DeSantls,Governor Halsey Beshears,Secretary Florida Dpr � t I STATE OF FLORIDA E ' '"ME DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE T- 1Tr RS & INSPECTOR THE STANDARD kOgPEtGE 'FLIED UNDER THE PROVISIOISRO ,71 t5 >�O`QZiD/�ST�TUTES KT Vi LA Ak LIC�IS�,��I1Jf�BI�•81�6�ij3 EXPIRATION DATE:NOVEMBER 30 2021 Always verify licenses online at MyFloridaLicense.com 1 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. Ran Dtsarah,GavNmr Hulsi}'BesWaM.SccmWe Y� id U",� STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS&INSPECTOR 'io THE STANDARD PLP�N5,WMIN,ER HI RIztN.IS CEaR�IF IEIJ UNIDER THE PROVISIONS OE�HAPT�k 448-,FLORIDA STATUTES CiLDG 4 E Y WILL-RA 1*1+�C3h�d �1LLE�' �IcE E NUMBtR..Oxi�c EXPIRAMN DATE: 1 6VEMBEK30,2421 A9,ns�y�verily I'rtrrnses 4n71ne ae MyRo�dallcense.cam n5© F Da nat:alter this document inanp form. ` ar This,fs year license-It 1s unlavaivl for anyone ether than the ficcnsce to use this document. k n®CSIn is.Goyemw Hakzty gcshcam sctreto � � tr STATE of FLORIDA dug 4 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS&INSPECTOR THE STANDARD INSPECTOR;HEREIN't'5:CEttrif[Eb UNDER THE PROVISIONS`OF.-C IAPTER 468;FLORIDA,-STATUTES ' t VIrFi, 1 'RAY_ Pw bN b A0 'lndltSAWMILL_WAY B:YOIVIrT-P®INT FL34fib7 <_ UCENS NUMRMR:9N2651 _j EXPIRATION DATE: NIOVEMBER 30,2021 A mayi verity Ikenses ordine at My+Ruiidi lcc-nsc.00m Do nut alter this document in any farm. Ia `. This is your license_It is unlawful for anyone other than the licensee to use this.document_ /Q4h Ron DeSantis,Governor Halsey Beshears,Secretary dbpr 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 CCI,BLDG,1&2,.PLUM,MECH VINES, DAVID L _ 1825 FOXBAYSDRIVE _ ,MELBOURNE.' FL-329,34,;y� � LICEN'SE'NUMBER:BN4842�a�p�t� d i EXPIRATION DATE: NOVEMBER 30,2021 Always verify licenses online at MyFloridaLicebse.com � 0 • 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. STUj. Ron DeSantis.Governor Halsey Beshears,Secretary CiCif�C' STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS & INSPECTOR THE STANDARD 1&2 FAMILY DWELLING:'PLANS"EXAMINER=HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 4.68, FLORIDA STATUTES ; . i VINES, D"lD L ` , � 1$25;FOX BAY DRIVE'FL 32934 N- :MEI.$QURNE:'': ''- LICENSE-'NUMBER:SFPiii a a EXPIRATION DATE: NOVEMBER 30,2021 Always verify licenses online at My FloridaLicensecom ■ ■ I Do not alter this document in any form. M This is our license.It is unlawful for anyone other n• 4 t than the licensee o ense t use this do ■ Y Y current. ; I Sri STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS&INSPECTOR (850)487-1395 dad 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399 WE 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 f to yacht brokers,from boxers to barbeque restaurants, STATE OF FLORIDA DEPARTMENT I and they keep Florida's economy strong. dbY'--z,r ROF BUSINESS EGULATION AND PROFESSIONAL i Every day we work to improve the way we do business in order to serve you better. For information about our PX2504 ISSUED:11/16/2019STANDARD 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 j 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 ❑� . 91 1825 FOX BAY DRIVE MELBOURNE FL 32934 ISSUED:11/16/2019 Always verify licenses online at MyFloridal-icense.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. SyIE 3j STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION 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 l.9 �• REGULATION Every day we work to improve the way we.do business in order to serve you better. For information about our BU ISSUED:11Jlb/2019 BUILDILDING 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. 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 VINES, DAVID L 1825 FOX BAY DRIVE MELBOURNE FL 32934 , %�r ISSUED:11/16/2019 Always verify licenses online at MyFloridaLicense.com Do not after 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=F00EEB9BO3C13941 E47AFABD74E34B8E 1/1 1/11/2021� DBPR-LLOYD,JAMES DEAN,Standard Inspector 12:25:55 PM 111112021 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/LicenseDetaii.asp?SID=&id=FBF81 D8634A8B2D70C07FAA05E27E08C 1/1