The URL can be used to link to this page

Home My WebLink AboutAlternative Service Agreement LOCATIONS Atlanta,GA Hagerstown,MD Pensacola.FL A Universal Buford,GA Wine.CA Port St.Lucie.FL Engineering Chantilly.VA N GAL Rooddde g FL 9 9 Charlotte.NC cilia• Sciences Clewiston,FL Las vegas.W Sarasota.FL Daytona,FL Miami.FL St Petersburg.FL Com an Defray Beach,FL Ocala.FL Tampa,FL P y Douglasville.GA Odando.FL Tifton.GA Fort Myers.FL Palm Coast,FL West Palm Beadi.FL Geotechnical Engineering I Construction Materials Testing and Inspections Fort Pierce,FL Panama City.FL Building Code Compliance I Environmental,Health 3 Safety I Facilities Consulting Gainesville.FL Pelham,AL Alternative Service Agreement Project: 7801 James Road Private Provider Firm: GFA International Private Provider Name: Address: 607 Commodity Cove, Port St. Lucie, FL 34986 Phone: (772)924-3575 Fax: (772)924-3580 Names, License/Certificate Numbers, and License description of provider and duly authorized agents who will be providing services for this project. Name: License/Certificate No.: License/Certificate Type: Matthew Chaney BN#7342 Inspector—Building Don Determan BN#4688 Inspector—Building (1 and 2 family), Plumbing Josean Duprey BN# 7330 PX#4208 Plan Review—Building, Inspector- Building Richard Jefferson BN# 1164 PX#513 BU# Plan Review—Electrical, Inspector—All Trades 1368 William McColman BN#7752 Inspector- Building Carl Peterson BN#5555 RPX# Plan Review—Residential, Inspector— MEP, Building Michael Banton BN#8067 Inspections— Building, Electrical, Mechanical , Plumbing, 1 &2 Family Ohl As the private inspection services provider for this project, I have read and agree to be b to the provisions of State Statute 553.791. 1 further agree and understand that only the above listed personnel may perform inspections on this project and that if for any reason the inspection personnel should change, or if any person listed above should discontinue to quality as a duly authorized agent, you will be notified in writing immediately. Representative Name: Si ature State of Florida, County of Palm Beach, er( � Sworn to(or affirmed)and subscribed before me this _day of k1bVeX VIA 2020, by IP 1'QV;i rA -VA who is personally known to me. ��urlv�on thoub � ••..LA10, Printed name of Notary pMM�ssip •. Signature of Notary V MASER 'L•. 41 Notary Public Stamp: *� 6�RES 'ce LOCATIONS A Universal """"'.GA _Hagetst°ee Bald.GA In".CA %fi Sl lsttle,Ft Engineering Chatwlllf.VA ,adoarn.e.Fl Alin.W 9 OsatloGe.He Kemal&.,GA Rodledge,FL Sciences CrwF1 lb�.Hv Saa.Ail FL Oaot .Ft Maim.Ft St powsh og.R Company oer,yBeadiJi OcAWFL ,amp.FL Ootgi.wb,GA Ortndo,F l Uton,GA Fat Myers.Fl Paim ConA Fl West Pa1M Beach Ft GeotechMcal Engine"I Corntruoian Meterlets Tway and Ins amm Fon Nerve.Ft Pww"City.Fl Building Code Convlli n e I FnvronnmeMsl He*"i Selety I FecMtles Consulting GA"Mole.Fl PaNtnn.A! Private Provider Plans Compliance Affidavit Private Provider Firm: GFA International Private Provider: Richard Jefferson Address: 607 NW Commodity Cove Port St. Lucie, FL 34986 Phone: (772)924-3575 Fax: (772)924-3580 Email: Scheduling@teamgfa.com Project Name: 7801 James Road Sheets: GRP2 0.2,GRP2 0.4, GRP2 1.0. GRP2 1.2. GRP2 2.3, GRP2 3.3 GRP2 .4,0, GRP2 4.3. GRP2 5.1 GRP2 6.2, SO.0 S 1.OB, S 1.1 B, SD2.0, FD 1.0, SD 1.0 I hereby certify that to the best of my knowledge, information, and belief he reference plans submitted were reviewed for, and are in compliance with, the Florida Building Code and all local amendments to the 2017 Florida Building Code by the following affiant, who is duly authorized to perform plans review pursuant to Section 553.791, Florida Statute of holds the appropriate license or certificate. John Carl Peterson RPX 243 Plans Examiner Richard Jefferson PX 513, BN 1164, BU 1368 Signature: Date: Private Provider State of Florida COUNTY of Palm Beach SWORN AND SUBSCRIBED before me on the day of 6oe *tioed, by Richard Jefferson, being personally known to me and who being state that the foregoing is true and correct to the best of his/her k I dg V� ova b o-q Signature of Notary Print Name: sj11111111FF, Notary Public Expires: I l Zo Notary Stamp: .•'��' L14 ► �f 'G60 F mm t, , ? ;• GG 914118 4c s EXPIRES .:m Sept 1 t,2029�:•r Sto s