HomeMy WebLinkAboutNotice to Building Official of Use of Private ProviderNotice to Building Official of Use :of Private Provider
Project Name: DR Horton - Creekside Lot 86 - 3419 Trinity Cir, Fort Pierce, Florida
Parcel Tax ID(s): 2327-502-0094-000-6
Services to be Provided: Plans Review X Inspections X
D.R. Horton Inc. , the fee owner, affirm I 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 Carl Peterson
Address- 607 NW Commodity Cove, Port St. Lucie, FL 34986
Telephone: 772-924-3575 Fax: 772-924-3580
E-mail Address: gfaschedulingo_universalengineering.com..
Florida License, Registration or Certificate No.- Florida License No. BU1721
I have elected to use one or more alternative providers to provide building code plans review and/or inspection
services on the building or structure that is the subject of the enclosed permit application, as authorized by
S.553.79.1; 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'l 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 in 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 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 I 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 forfire code, land use, environmental or other codes:
Notice to Building Official_U,ES BID Form Page 1 of 2 04/19 R1.0
The f6.11owi.ng attachments are provide as required -
I Qualificafion. statements 6nd/or resumes of the
private provider: and all duly authorized
representatives.
2. Proof of insurance for professional and comprehensive
liability. in the amount of.$1 million per
occurrence relating to all services performed as'a private provider, including tail coverage for a
minimum of 5 years subsequent to the performance of building code inspection services.
Individual Corporation
Partnership
DR Horton Inc
Print Cbi06rati_pdName
Print Partnership Name
...... By
By:
(signature). (signature)
(signature)
Print Print
Print
Name: Name: Brian W. Davidson
Name:...
Address'. its: Assistant Secretary
Its:
Address; 1430 Culver Dr:NE;
Address:
Telephone Palm Bay, FL 32907
No.:
Telephone
-Telephone
No. M-73$-7972
No.:
Please use appropriate notary block.
STATE OF Florida
COUNTY OF Brevard
Individual
Corporation
Partnership
is day of
Before me, this
Before me, this 13 . day, of
Before me, this day
?.20 personally
APRIL - 20�21
of 20—, personally
appeared
personally appeared
appeared
who executed the foregoing instrument,
Brian W. Davidson of
partner/agent on behalf of
and acknowledged before me that'same
DR Horton Inc a
was executed for the purposes therein
corporation, on
a partnership who executed the
expressed.
behalf of the state corporAti6nj Who
foregoing instrument and acknowledged
executed the foregoing instrument and
before me that game was executed for
acknowledged before me that same. Was
the purposes therein expressed.
executed for the purposes therein
expressed.
Personallyknown V - or Produced identification
type of identification produced
Signature of Notary Print Name
Notary Public: NOTARY STAMP BELOW .... . ..
My commission expires: o5om! "N DINAPARRINO
MY COMMISSION # GG 935643
'V EXPIRES: February 27,2024
Bonded Thru Notary Publk Underwitters
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