HomeMy WebLinkAboutNotice to Building Official of Use of Private ProviderNotice to,sditding Offici,aFOUs'e-of,Private Provider'
Project Name: ;,'DR Horton = Cre'ekside PLat.#4, Lot-.6 - 3327 Homestead Drive, Fort.Pierce; Florida
Parcet'TaxID(s): 2,327-502-0014=000-2 '
• r
Services to be,Qrovided Plans Review ' X Inspections. .X
- � 1, .._ • • -. >: .
D.R. Ho'rfo'n Inc. the fee owner, affirm 1 have entered into a contract with
the Private Provider Indicated _below to conduct the services indicated above:
Private Provider Firm:,, • Universal Engineering Sciences
Private Provider: .John Cail,Peterson
Address:-'' 607'NW, Cornmodity`Cove, Port St: Lucie, FL 34986-
Telephone: , 772424-3575 Fax: 772-924-3580
E-mail Address: gfaschedulingCaD-universalengineering.com
Florida License; Registration or Certificate No.,-.,, Florida L cerise .N.6. BU1721 .,
I.have elected to use one,or_rriore alternative providers to provide,buildiing code plans review.arid/or inspection: '
services on. the -building or -structure that is the subject" of the enclosed permit- application, -as ,authorized by
S.553.791, Florida Statutes: 1 understand that,the•local building offcial may not review the plans ubmitted':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'b.ulldiiig inspections. will b performed by
licensed or certified personnel identified in the application. The law rega'ires 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:i•nterests are adequately protected..l: agree
to indemnify, defend, and hold harmless the local government, the local building official, avid 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 or structure 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 l make' any changes to the listed private providers or the services to,be,provided by those private providers,
I'"shall;.,within 1 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.
Notice to Building Official —LIES BID Form Page 1 of 2 04/19 R1.0
The following attachments are provide 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
' al -
occurrence relating to all. services perfonned as a private provider,, including tail coverage for a
)el,
minimum of.5 years subsequent to the performance of building code inspection services.
le
Individual . Corporation "' ", _ Partnership
.ion
DR Horton lnc'
;rton li
_
Print C!r,�,orat�Name . Print Partnership Name
By _— By:
--
(signature) (signature) . (signature)
Print Print Print
Name: Name: Brian W. Davidson Name:
F
Address:. its: Assistant Secretary Its:
Address: 1430 Culver Dr NE, Address:
Telephone Palm Bay, FL 32907
No. --
- Telephone Telephone
No. 321-733-7972" No.:
Please use appropriate notary block.
STATE OF " Florida
COUNTY OF Brevard =
Individual Corporation Partnership
Before me, this - _ day of Before me, this .16 day of Before me, this day
u_ .20 , personally FEBRUARY 202 , of _; 30 _ -,personally .
appeared" _ _ -_ _ personally appeared appeared
who executed the foregoing, instrument, Brian W. Davidson _._.. of partner/agent on behalf of
and acknowledged bef6mme'that same DR Horton Inc _ , 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.
Personally known •_V- ; or Produced identification, ___Type of identification produced-
Signature of Notary Print Name
Notary Public; NOTARY STAMP BELOW
My commission expires: DINAPARRINO-A% ..
_: MY COMMISSION # GG 935643
Po? EXPIRES: February27,20
Fig.24
Q Bonded nra.Nolw. Public Underwriters
2of2 :.