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Home My WebLink AboutAlternative Service AgreementGrounded in Excellence GeotechnicaI!Enginee ring Construction IMaterials Testing & Inspection Building Code Compliance OccupationallHealth & Safety Environmental Building Envelope Alternative Service Agreement Project: Ocean Glass Residence Retaining Wall-10101 South Ocean Dr. Jensen Beach, FL 34957 Private Provider Firm: Universal Enaineering Sciences Private Provider Name: John Carl Peterson 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: Kevin Hempel BN2335 Inspector —Building, Mechanical, Electrical, Plumbing i Don Determan BN4688 Inspector — Building (1 and 2 family), Plumbing Josean Duprey PE92178 Inspector - Building Carl Peterson BN5555 Inspector — MEP, Building Michael Benton BN8067 Inspector— I nspector-Building (1 and 2 family), Mechanical, Plumbing Donald Green BN7301 Inspector -Electrical i Vincent Burdo BN5337 Inspector -Mechanical, Electrical, Plumbing Clyde Thirbenny BN4046 Inspector -Building, Mechanical, Plumbing Michael Ma all BN3847 All Trades Matthew Chaney BN7342 I Inspector -Building As the private inspection services provider for this project, I have read and agree to be bound 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. John Carl Digitally signed by John Carl Peterson bate: 2022.01.11 Representative Name: Pet2.r$011,. 14.43:36-05'00' ` Signature State of Florida, County of St. Lucie, Sworn to (or affirmed) and subscribed before me this day of : , 202 by4TQhn C. L't�� who is personally known to me. _Q, 1X.�\4.�� Printed name of'Notary gignasture of Notary Notary Public Stamp: (O"',�46"ded JENESSA WE1TE FUNESNotary Public •State of FloridaCommission# HH 130136 My Comm. Expires May 16, 2025 through National Notary Assn. wUNIVER'SAL' ENGINEERING SCIENCES Ocean Glass Retaining Wall 10101 S Ocean Dr. Jensen Beach, FL 34957 Private Provider Plan Compliance Affidavit Private Provider Firm: Universal Engineering Sciences Private Provider: John Carl Peterson Address: 607 NW Commodity Cove, Port St. Lucie, Florida 34986, Phone: 772-924-3575 Fax: 772-924-3580 , Email:gfascheduling(a),universalengineering.com I hereby certify that to the best of my knowledge and belief the plans submitted were reviewed for and are in compliance with the Florida Building Code and all local amendments to the Florida Building Code by the following affiant, who is duly authorized to perform plans review pursuant to Section 553.791, Florida Statute and holds the appropriate license or certificate: Name: John Carl Peterson Plan Sheets: 1 of 1 Florida License/Registration/Certification #(s) and description: John Peterson PX 2764 .John Digitallysigned by John Carl Carl Peterson Date::2022.01.12 Signature of Reviewer: Peterson to:02s9-os'00' ,f SWORN AND SUBSCRIBED before me by John Carl Peterson, BU#1721 being personally known to me or having produced as identification and who being fully sworn and cautioned, state that the foregoing is true an correct to the best of his/her knowledge or belief. ignature of N=RYVTAMP rint Name Notary Public: BELOW My commission expires: W1("%, � It kk n.. e) (-")i JEN—ESSA YYEM FUNES Notary Public . State of Florida Commission of HH 130136 My Comm. Expires May 16, 2025 ed through National Notary Assn. Notice of Building Official of Use of Private Provider Project Name: Ocean Glass Residence Retaining Wall-10101 South Ocean Dr. Jensen Beach, FL 34957 Parcel Tax ID: Services to be provided: Plan Review x Inspections X Note: If the notice applies to either private 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. as 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 Email Address (optional): gfascheduling(cD-universalengineering.com Florida License Registration or Certificate #: 13U1721 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 code, 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 required 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 certifiedpersonnel 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 orthe services to be provided bythose 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. The following attachments are provided as required: 1. Qualification statements and/or resumes of the private provider and all duly authorized representatives. i 2. Proof of insurance for professional and comprehensive liability per Florida Statutes s.533.791 (1b). Individual Corporation Partnership Print Corporation Name Print Name By: (signature) By: Print name Print name Address: Address: (signature) Print Partnership Name By: Print name Address: Phone #: Phone #: Phone Please use appropriate notary block. STATE OF Florida COUNTYOF Individual (signature) Before me, this day of 20_, personally appeared who executed the foregoing instrument, and acknowledged before me that same was executed for the purposes therein expressed. Corporation Beforeme,this dayof 20 , personally appeared of e corporation, on behalf of the state corporation, who executed the foregoing instrument and acknowledged before me that same was executed for the purposes therein expressed Partnership Before me, this day of _ 20_, personally appeared partner/agent on behalf of a partnership, who executed the foregoing instrument and acknowledged before me that same was executed for the purposed therein expressed. Personally known ; or produced identification type of identification produced Signature of Notary Notary Public: NOTARY STAMP Print Name My commission expires: MICHELLE R. MILLER, CLEt.. JF THE CIRCUIT COURT SAINT LUCIE COUNTY AFTER RECORDING • RETURNTO: FILE# 4954078 11/18/202108'46:45AM r OR BOOK 4723 PAGE 178 -178 Doc Type: NC RECORDING: s10.00 PLRMIT NUMBER: NOTICF.OF COINI\•I HNC HNILENT The undersigned huruh% gives notice that intprovcnlcnt will he made Io retrain real Property. and in accorthmce with Chapter 713. Florida Status, file lollotting inlarmation is provided in this Notice tirComntencument. DESCRIPTION OF PROPF.RTI• (Legal description ot'the property 8: street address. il'a\ailable) TAX FOLIO NO (PCN).: 4502-801-0008-000-8 I.eg;11 Descl'ipfioll 2/11-37-41 FROM NW COR GOV LOT 1 SEC 11 RUN N 89 DEG 30 MIN W 57 FT TO SE COR TRACT G, TH N 22 DEG26 MIN W ALG ELY LI TRACT G 712.8 FT TO N LI T 2. cEn'r.R:\Lnrsc RrnTION OFIAIPIiovlE�niNl: Construction of 28 town homes community 3. OWNIER INFORMATION OR LESSEE INFORMATION IF'1,11K. L ESSIEF. CONTRA(7ED FORTH E UNIPRO\rMME"N'1': it. Name and addrese..SeaGlass Ocean Dr.Development LLC,1111 Kane Concourse,Bay Harbor Islands 3315, b. Interest in property 100% Ownership c. Name and address of lac simple titleholder 1 i 'dillarent from Owner listed ahovey ,--_ 4. a. CONTRAC"I'OR'S NANI E: Bayview Construction Services Contractor'saddress. 4826 SE Railway Ave, Stuart, FL 34997 b. Phone number. (772) 283-9300 i. SURETY (il'appbcable, a copy ol'thc payment hand IS clutched). a. Amount ol'hund. _ b: Phone number: e. Name and address:, ----..._._.....__ .. _.. ..._....... 6. a. LENDER'S -NAME.: NWL 2016 Evergreen LP FL (305) 528-6846 I..ender's;lddres, 3323 NE 163rd St, PH #704, North Miami Beach, a ' _ W. I hone number: 7. Persons within the Bone ol'Florida designated by Ownct upon whom notices or other docuntenfs may be served as provided by Section 713.13 ( I ) (a) 7.. Floridu Statutes: a. Namcandaddress Igal Zakhodin, 1111 Kane Concourse ,Ste 209, Bay Harborlslands 33154 b. Phone numbers ofdesignmcd persons: 2123650830 3, a. In addition to hnnsell'or herself. O%vner Section 713.13 (1) (hi. Florida Statutes. receive a copy ol'the Licnor's Notice as provided in b. Phone number ol'llerson or entity designated by (Amer:-_------___-- 9. Expiration date of* notice ol'connnencentent (the expiration d;ue will he I year Irom the date oll'ecording unless a dillcrent date is'specifed): 04 , ZO 2 \YARNING TO O\VN1i1< AN\' I'I Its OWNHR Al- I'litCOMMIENCGtv1ENT AR1: CONSID13RED IN411ROPFR PAYN(EN'TS UNDER (_1IAPTI:R 713. PART I. SISC PION 713.13. 1: I)RII)A STA-1'171'I:S. AND CAN RESUI: r IN YOUR BAYING TWICE FOR INIPROVE 0ENPS •1'0 YOIJR iVnl a of cner ur Lessee, or Owner's or I.essce's ^r nt N;one and Provide Siguatory's Title/Office) t nrii Officer/Ilircctnr/I'arUlcr/\tanager) State of LO,2r+��7�1- ('ounIV nt'_ %t � The loregoing instrument trots acknowledged before me by means of physieal presence or Qunlinc notarization. Ellis —C,06davnl'OQ-7— --'Z(I-----11y�.!;' 'L 2-A1_-R0V hn•,unc ol'person) finti(_/L��S gce�h (name nfpy on all'ul'avhnm insininionl was executed) (type irmnhority...0 ;. arrace , trustee, attorney in ruct) Personally Known Q _or Produced Idunulictnton 'I')pe oil' Identification Produced __ � Notary (. t u •c ft'ut:n•y Public) ov (Print, ype, or St n1 tissioned Name ol'Nutary Publie) e o:. VINCENZO ZURLO �2.. �: •� Notary Public -State of Florida o� a 17_11R.711 Commission = GG 362031 Rna. .. _