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HomeMy WebLinkAboutPrivate Provider Certificate of Inspections & ComplianceI ST LUCIE COUNTY CODE COMPLIANCE DIVISION 2300 Virginia Avenue Ft Pierce, FL 34982 Office (772) 462-1553 Fax (772) 462-1148 Private Provider Certificate of Inspection(s) / Compliance: (Revised July 1, 2003) St Lucie County Code Compliance Division PERMIT #: 0512— — 010 � DATE: `7- 2© - icoo STREET ADDRESS: PARCEL #: LEGAL BLOCK LOT TO: St. Lucie County Building Department To the best of my knowledge and bel�ef, as a private provider, as authorized in s. 553.791, Florida Statutes, the building components and site improvements outlined herein and inspected under my authority have been completed in conformance with the approved plans and/or applicable codes and standards, as well as all related permit documents. In the event of a conflict between codes and documents, the more restrictive is applied. 1 further certify that the structure, electrical, gas, in chanical and plumbing systems (as applicable) have been erected in accordance with requirements of the technical codes. 1 affirm that 1 am qualified under s. 468, Florida Statutes, to provide building inspection services as authorized by s. 553.791, Florida Statutes. It is understood that the undersigned hereby accepts the responsibilityfor performing all of the required inspections identified in this document. 1 certify that inspections were performed (and passed) as detailed in Section 105 of the Florida Building Code, the permit card, and as prescribed by the local authority having jurisdiction. i Inspections: (Please type / print inll pections as required) 1) 2) (Inspection Type) (Date) (Inspection Type) (Date) 3) 4) (Inspection Type) (Date) (Inspection Type) (Date) 5) 6) (Inspection Type) (Date) (Inspection Type) (Date) 7) 8) (Inspection Type) (Date) (Inspection Type) (Date) 9) 10) (Inspection Type) (Date) (Inspection Type) (Date) I ***ATTACH ADDITIONAL Architect / Engineer: (PRINT NAME OF ARCHITECT/ (DATE) (ADDRESS) NOTARY: STATE OF COUNTY OF The foregoing instrument was acknc By Personally Known Produced Signature of Notary Public — State o Inspector as recognized s 468 FS: DBPR Applicable License #s (PRINT NAME OF INSPECTOR) (DATE) ETS AS REQUIRED TO DOCUMENT ALL INSPECTIONS*** #: of (SIGNATURE OF ARCHITECT/ ENGINEER) (PHONE #:) Architect / Engineer Seal: before me this day of My commission expires: Type of identification: (SIGNATURE OF INSPECTOR) (PHONE #:) 200_ (ADDRESS)