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HomeMy WebLinkAbout Private Provider Plan Review & InspectionNotice of Building Official of Use of Private Provider Project Name: Creekside Lot # 59, 9225 Potomac Dr. Fort Pierce, Florida Parcel Tax ID: 2327-502-0067-000-8 . . 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. I. D.R. Horton, Inc. 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): gf6scheduling(aD-universal6ngineering.com Florida License Registration or Certificate #QU172 r 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 certified personnel 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 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. 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 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 (signature) Print Name: Address: Telephone No.. Please use appropriate notary block. STATE OF Florida COUNTY OF Brevard Individual 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 DR Horton Inc Print Corporati ame By: (signature) Print Name: Brian W. Davidson Its: Assistant Secretary Address: 1430 Culver Dr NE, Palm Bay, FL 32907 Telephone No. 321-733-7972 Corporation Partnership Print Partnership Name M (signature) Print Name: Its: Address: Telephone No.: Before me, this day of February 2022 , personally appeared Brian W. Davidson of DR Horton Inc , a 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 purposes therein expressed. Personally known V ; or Produced identification Type of identification produced Signature of Notary Notary Public: NOTARY STAMP BELOW My commission expires: DINAPARRINO MY COMMISSION # GG 935643 4c EXPIRES: February 27, 2024 2 Of 2 'rFCC i��a`� Sonded Thru Notary Public Undeimilers Print Name UNIVERSAL® ENGINEERING SCIENCES. DR Horton-Creekside Cali Lot 59 9225 Potomac Dr. Fort Pierce, FL Private Provider . Plan Compliance Affidavit California Model-9700 Potomac Drive Private Provider Firm: ..Universal Engineering Sciences _ Private Provider: John Carl Peterson Address:.. 607 NW Commodity.. Coye,Port St.: Lucie, Florida 34986 Phone: 772-924-3575 Fax:. :7727924=3580 . Email: inetersonl'a..universalenaineerina.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.. Revised Plan Sheets: Cl, GN, Al, A2D, El, P1, D1, .D2, Florida License/Registration/Certification #(s) and description: John Carl Peterson RPX 243 John.Carl Digitally signed by. ,�John Carl Peterson J Date:.2022.02.18 Signature of Reviewer: P$t2r5011"or27:07 s oo 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 and correct to the best of his/her.knowledge or belief.S L'A'A - i Signature of Notary Print Name T Notary; Public: NOTARY STAMP BELOW 1VIy commission expire�s�%""""'���,, ��,....:,11 L Youg,,�.;��• GG 814118 4 EXPIRES �scc 0. :. Sept 17, 2073; :C. , ACORI®� �- CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIVYYY) 2l912022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: IF the certificate holder is an ADDITIONAL INSURED, the policy(Ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). Beecher Carlson Insurance Services a Brown 81 Brown company TAIPRODUCER CON ; : Lynda Volpe PHONE FAX 6 Concourse Parkway, Suite 2300 Atlanta, GA 30328 E. L - o e • L nda.voe a bbravn,com MSURER[SJ AFFORDING COVERAGE NAIC a INSURERA: Everest National Insurance Company 10120 www.bbinsuranco.com INSURED GFA International, Inc., DBA Universal Engineering Sciences 3532 iblaggggie Blvd INSURERS: Everest Premier Insuranoe Company 16045 INSURERC: SlarStone Specialty insurance Company 44776 INSURERD: AXIS Surplus Insurance Company 26520 IHSURERE: Evanston Insurance Company 35378 Orlando FL 32811 INSURER F : Landmark American Insurance Companv 33138 COVERAGES CERTIFICATE NUMBER: FRR7�77R REVISION NUMBER! THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ITR TYPE OF INSURANCEis= ADDL SUBR Jim POLICYNUMBER POLICY EPP IMMMI11YYYY1 POLICY EXP INIMIDorrimUNITS A ;j COMMERCIALGENERALUASILITY p p RMSGL00056-221 11112022 11112023 EACH OCCURRENCE S10OD000 CLAII.IS-MADE F 10 OCCUR PREMISES Me ocuirreaW$100,000 ❑ MED EXP (Any oneperson) $10 000 Blanket Contractual Liability PERSONAL & ADV INJURY $1 000 000 GEN'LAGGREGATELIMITAPPLIESPER: POLICY El JEc LOc GENERAL AGGREGATE $2,000,000 PRODUCTS - COMPIOP AGG $ 2 000 000 Employee Benefits S 1,000 000 OTHER: A AUTOMOBILE LIABWY H U RM5CA00056.221 1/112022 11IM23 COMBINED SINGLE LIMB $3 004 000 BODILY INJURY (Per person) S ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per ecddenO $ PROPERTY DAMAGE S S F UMBRELLA LIAB Q OCCUR i7 L7 LHAO96670 11/12022 1IM023 EACHOCCURRENCE s2,000000 AGGREGATE $2,000,000 1—DED EXCESS LIAB CLAIMS -MADE F I RETENTIONS S B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ECUTIVE ® O FFICERIIMEMMBBER EXCLUDED? NIA p RM5WC00084-221 (AIDS) RM5wC00085.221 (Fi NJ ME) ' ' 1IM022 11112022 1IM023 119/2023 p PER UTE OTH, E.L. EACH ACCIDENT S'1,004,000 E.L. DISEASE -EA EWPLOY $ (Mandatory In NH) It yes, deerilbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT 31,000,000 E Professional Liability MKLV7PL4005114 21112022 2/112423 Per Claim $5,000.000 Aggregate $5,000,000 C Excess General Uab. ($4M xs of $1 M) 77102C221ALI 1/112022 111/2023 Limit $4,000,000 D Excess Auto Liability $21A xs of S3M P-001-000760170-01 111/2022 11112023 Limit $2 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Romorks Schcdu1% may bo attachod If rnwo spaco Is rmrs9rod) Creekside Lot 59, 9225 Potomac Dr. FL Pierce, FL 34945 CERTIFICATE HOLDER CANCELLATION St. Lucie County Building Department 2300 Virginia Avenue Port St. Lucie FL 34982 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZEDREPRESENTATIVE � eliT�ACr�t .7101 •vane( SclrvJl`LD� � Beecher Carlson Insurance Services, LLC ®1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 6667377E I Ei8 22-23 G1A International, Inc., I L;mda Val pa 1219/2922 9t39r35 hPo (=571 I Page ] at 1 This certificate cancels and supersedes ALL previously issued certificates, Geotechni.cal'Engin e6ring Construction Materials Testing & -Inspection Building Code Compliance occupational Health & Safety. Enviro.nmenta4 Building.Envelope• Alternative: Service Agreement Project: DR Horton-Creekside — 9225 Potomac Drive, Fort Pierce, FL 34945=Lot 59 Private Provider Firm: Universal Engineering Sciences.. Private Provider Name: John Carl Peterson . Address:.607 Commodity. Cove, Port St.. Lucie ,.FL 34686 - Phone: (772) 924-3575' F6x:.(7.72) 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/Cedificate.'Type: Matthew Chaney " " BN 7.342 Inspector= Building '. Don Determan .. BN 4688. : Inspector.= Building. (I'and 2'family),' Plumbing . Joseph Duprey . - PE 92178 , .. Inspector. -Building .. Carl Peterson BN 5555 .. Inspector.=:MEP, Building William McColman : BN 7752 Inspector= Building .' Donald Green. BN 7301 Inspector -Electrical Juan C: Hernandez .. PE 58638 Inspector- Mechanical Paul Desentz BN 7609 Inspector.=.Building.: Richard Jefferson. BN 1164 Inspector- Building, Electric, Mechanical;' Plumbing - Clyde Thirbenn BN-4046:: Ins ector =: Buildin , Mechanical, Plumbin . Raymond Gendron : I BN 4955 : :Ins ector - Buildin 1 and'2 famil ,Electrical .: 71 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. Digitally signed by 0 n. Ca r John Carl Peterson Representative Name: Dctorcnn --Date: 2022.02.09 r.` -05 W.Signature State of Florida,, County of Palm,Beach, day of . C , 202 b •Sworn to (or affirmed) and subscribed before me this y '�, ,.. who is personally known to me. Printed name of Notary Signature of:Nota Notary Public Stamp: : M, , LINAMARIASIFUENTES t Commission # GG 262173 + �,°•,? Expires September A 2022 'OF F ° • .7019 Bonded TMu TrOr F�In tnSwaiMe 800 385 4Qoars� -- �m CITY OF PORT SAINT LUCIE BUSINESS TAX RECEIPT w PLEASE POST IN CONSPICIOUS PLACE OR KEEP ON PERSON �40RM" Term:10/01/2021 — 09/30/2022 2021 -2022 Business Address: 607 NW COMMODITY COVE Business Name: UNIVERSAL ENGINEERING SCIENCES Mailing Address: 607 NW COMMODITY COVE PORT ST LUCIE, FL 34986 Category: Category 3 PROFESSIONAL Additional Data: ENGINEERING FIRM BTR#: 127198 Date Made: 09/01/2021 WV% 8"j- Ga�` Business Tax Authority $134.00 Total Tax Paid: $134.00 THIS IS A RECEIPT FOR TAX PAID AND IS NOT REGULATORY IN NATURE This receipt does not warrant that the receipt holder is competent to perform in the business, but that the holder has paid the required tax and provided the necessary documentation (if required) for this business. Valid only when all state and local regulated trade licenses/competency cards are valid for the current fiscal year as required by law. ,s �'�''•C'fio i 4777d,;-• A Universal Engineering Sciences Company YEARS OF EXPERIENCE 5 EDUCATION BS IN CIVIL ENGINEERING, FLORIDA ATLANTIC UNIVERSITY (2016) LICENSES & CERTIFICATIONS FLORIDA STANDARD BUILDING INSPECTOR, BN7342 MATTHEW CHANEY Inspector SUMMARY OF QUALIFICATIONS Enthusiastic Structural/Geotechnical Engineering professional with a positive attitude and a strong focus on quality and service, who is capable of achieving goals in both individual and collaborative settings with excellent attention to detail, verbal, and written communication skills. SELECT PROJECT EXPERIENCE 5000 N. Ocean (North Palm Beach, Florida) Inspector This project consisted of the new construction of a 20-story condominium. Mr. Chaney was responsible for performing Threshold Inspections such as, but not limited to reinforced masonry, post tension, concrete placement monitoring, red iron, and all other interior nonstructural inspections. Alta Delray —Delray Beach, Florida Inspector This project consisted of the new construction seven 4-story apartment buildings. Mr. Chaney was responsible for performing Threshold Inspections such as, but not limited to reinforced masonry, post tension, concrete placement monitoring, wood frame, precast concrete and all other interior nonstructural inspections. The Waterclub — (North Palm Beach, Florida) Inspector This project consisted of the new construction of two, 23-story condominiums. Mr. Chaney was responsible for performing Threshold Inspections such as, but not limited to reinforced masonry, post tension, concrete placement monitoring, red iron, and all other interior nonstructural inspections. Watercrest — (Parkland, Florida) Inspector This project consisted of the new construction of458 one and two-story single family homes. Mr. Chaney was responsible for performing Special Inspections, including reinforcement of slab on grade, unit masonry, roof and wall sheathing, and truss engineering. PGCC — (Parkland, Florida) Inspector This project consisted of the construction of 386 one and two-story single family homes. Mr. Chaney was responsible for performing Special Inspections, including reinforcement of slab on grade, unit masonry, roof and wall sheathing, and truss engineering. 3550 S. Ocean — (South Palm Beach, Florida) Inspector This project consisted of the new construction of a 5-story condominium. Mr. Chaney was responsible for performing Threshold Inspections such as, but not limited to: reinforced masonry, post tension, concrete placement monitoring, red iron, and all other interior nonstructural inspections. 10 Ron DeSantis, Governor Julie I. Brown, Se STATE OF FLORIDA JEPARTIVIENT OF BUSINESS AND PROFESSIONAL REGU BUILDING CODE DMMI t RS & INSPECTOI r THE STANDARD : T G 9.. ., `I D UNDER THE PROVISIO :SF,D)4'D�fATUTES t{'r-,_�' 101 M EXPIRATION DATE: NOVEMBER 30, 2023 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this d. GFA INTERNATIONAL, INC. 607 Northwest Commodity Cove Port St. Lucie, Florida 34986 Phone: (772) 489-9989 Fax: (772) 489-2989 TeamGFA.com DON DETERMAN Building Inspector/Plans Examiner Mr. Determan has over thirty-seven (37) years of experience in the building inspections and plan review industry. Mr. Determan has a comprehensive understanding and knowledge of the most recent technical building codes and has ample experience performing field inspections on many high-rise threshold buildings, as well as various municipal and special inspection projects. Select Project Experience TOWN OF JUPITER BLD001-2013/DG PLAN REVIEW, INSPECTION SERVICES AND PERMIT TECHNICIANS • JUPITER, FL • Mr. Determan provides the Town of Jupiter with Plans Review, Inspection Services and Permitting services on an as -needed basis for projects within the Town of Jupiter. CITY OF SEBASTIAN PLAN REVIEW & INSPECTIONS ® SEBASTIAN, FL • Mr. Determan provides the City of Sebastian with Plan Review and Inspection Services on an as -needed bases for projects within the City of Sebastian. CLARITY POINTE Q STUART, FL • This project consists of the new construction of a one-story memory care facility located in Stuart, Florida with a footprint of approximately 55,000-square feet. Mr. Determan is performing special inspection services for precast concrete units, engineered unit masonry, connections, metal systems building, truss erections, weld inspections, and bolt inspections. AZURE CONDOMINIUMS s PALM BEACH GARDENS, FL This project consists of the new construction of two, 5-story residential structures totaling approximately 575,000-square feet. Mr. Determan is performing threshold inspection services for reinforcing steel placements, shoring and re -shoring inspection verification, concrete and grout placement monitoring, pre and post fill cell grouting, structural steel, welds, connections, and exterior window and door attachments. ST. LUCIE COUNTY TAX COLLECTOR OFFICE m TRADITION, FL • This project consists of the new construction of a 1-story, 22,000-square foot building to house a new St. Lucie County Tax Collector office in the Tradition area of St. Lucie County, Florida. Mr. Determan is performing special inspections on engineered unit masonry, connections, weld inspections, bolt inspections, and curtain walls. Education A.A., BUSINESS, SACRED HEART EARLY, IOWA Professional Registrations STANDARD INSPECTOR, BN4688 BUILDING INSPECTOR, BN4688 1 & 2 FAMILY DWELLING, BN4688 PLUMBING INSPECTOR, BN4688 STANDARD PLANS EXAMINER, PX2466 BUILDING PLANS EXAMINER, PX2466 SEMINOLE COUNTY RFP-603520-19rrLR Term Contract For Licensed Plans Examiners And Inspection Services 26 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida,s economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department,s initiatives. Our mission at the Department is. License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! F�nd, STATE OF FLORIDA DEPARTMENT dopr OF BUSINESS AND PROFESSIONAL REGULATION BN4688 ISSUED, 10/29/2021 STANDARD INSPECTOR DETERMAN, DON L Signature LICENSED UNDER CHAPTER 468, FLORIDA STATUTES EXPIRATION DATE. NOVEMBER 30, 2023 Ron DeSantis, Governor Julie I. Brown, Secretary STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS & INSPECTOR LICENSE NUMBER. BN4688 EXPIRATION DATE. NOVEMBER 30, 2023 THE STANDARD INSPECTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 468, FLORIDA STATUTES DETERMAN, DON L 2401 CANOE CREEK LN FT PIERCE FL 34981 ISSUED. IW29/2021 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. JOSEAN A. DUPREY, E.G. Inspection Department Manager / Inspector / Plans Examiner SUMMARY OF QUALIFICATIONS Mr. Duprey is the Inspections Department Manager for the Port St. Lucie, Florida branch of GFA International, Inc. Mr. Duprey has over ten years of experience in the construction industry with extensive knowledge and engineering skills in construction materials testing and special and threshold inspections. He is also experienced with performing building plans review. EXPERIENCE GFA International, Inc. 2019 - Present Inspection Department Manager Mr. Duprey is the current Inspections Department Manager for the Port St. Lucie branch of GFA International. His responsibilities include managing daily inspections department operations, performing inspections and plans review as needed, managing client relations, supervising the inspections staff, and performing project management for inspections and plans review contracts. Town of Jupiter Plan Review, Inspection Services & Permit Technicians Continuing Contract - Jupiter, FL Contract Manager Mr. Duprey is serving as the contract manager for GFA's continuing contract with the Town ofJupiterto provide professional building inspections, plan review services and Permit Technicians for all town wide construction projects. Mr. Duprey is responsible for coordinating with the town to provide staff as needed and overseeing GFA's assigned staff members. City of Palm Bay Inspections and Plans Review Services Continuing Contract - Palm Bay, FL Contract Manager Mr. Duprey is serving as the contract manager for GFA's continuing contract with the City of Palm Bay to provide professional building inspections, plan review services for all city-wide construction projects. Mr. Duprey is responsible for coordinating withthe City to provide staff as needed and overseeing GFA's assigned staff members. City of West Palm Beach 2018 - 2019 Building Code Plans Examiner Mr. Duprey was responsible for performing building plans review services for projects within the City of West Palm Beach. ECS Limited 2017 - 2018 Construction Material Staff Project Manager Mr. Duprey was responsible for overseeing all construction materials staff who were performing soil densities, concrete testing, fireproof testing, stucco testing, special and threshold inspections, facilities and building envelope services, geotechnical services, and environmental services. 4FCRNATION" YEARS OF EXPERIENCE 10 YEARS WITH THE FIRM 1 EDUCATION B.S., CIVIL ENGINEERING/PROJECT MANAGEMENT, UNIVERSITY OF PUERTO RICO — MAYAGUEZ, 2009 LICENSES & CERTIFICATIONS • FLORIDA ENGINEERING INTERN #2100022345 • STANDARD BUILDING INSPECTOR, BN7330 • STANDARD BUILDING PLANS EXAMINER, PX4208 GFA International, Inc. www.TeamGFA.com Ron DeSantis, Governor STATE OF FLORIDA BOARD OF PRO EW- ONAL ENGINEERS . • • • •,Q , o- .,�e hn kJTES DUP 1 .fir 1 � r ✓'�1 � � aw � � ;. EXPIRATION DATE: FEBRUARY 28, 2023 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. FBPE FLORIDA BOARD OF PROFESSIONAL ENGINEERS JOHN CARL PETERSON Building Official/Inspector/Plan Examiner SUMMARY OF QUALIFICATIONS Mr. Peterson has over thirteen years of experience as a Building Official, Code Administrator, and Building Inspector. He has served as the building official for Saint Lucie Village, the Village of Indiantown, and has served as a Building Code Administrator for the St. Lucie County Board of County Commissioners and as a Building Inspector for Okeechobee County. EXPERIENCE GFA International, Inc. 2019 - Present Inspector Mr. Peterson currently serves as a Building Official for GFA International, Inc. Currently, he is overseeing the Village of Indiantown as building official under GFA's continuing contract. Village of Indiantown Annual Contract for Uniform Building Code Inspection Services — Indiantown, FL Building Official/ Inspector/ Plan Examiner Under GFA's continuing contract with the Village of Indiantown to provide Uniform Building Code Inspection Services for village -wide construction projects, Mr. Peterson serves as the Building Official, provides multi -discipline code compliance inspections, and multi -discipline plan review services on various projects on an as -needed basis. St. Lucie County Board of County Commissioners 2012 — 2019 Building Code Administrator Certifications Building Inspector, Mechanical Inspector, 1&2 Family Inspector, Costal Inspector, Building Plans Examiner, Mechanical Plans Examiner, 1&2 Family Plans Examiner, Building Code Administrator, Certified Flood Plain Manager Okeechobee County, Florida 2008 — 2012 Building Inspector Certifications Building Inspector, Mechanical Inspector, 1&2 Family Inspector, Costal Inspector, Building Plans Examiner, Mechanical Plans Examiner, 1&2 Family Plans Examiner, Building Code Administrator, Contractor Licensing IFRNATIO'"' YEARS OF EXPERIENCE 13 YEARS WITH THE FIRM <1 EDUCATION HIGH SCHOOL DIPLOMA LICENSES & CERTIFICATIONS • BUILDING CODE ADMINISTRATOR, BU1721 • STANDARD BUILDING INSPECTOR, BN5555 • 1 & 2 FAMILY DWELLING INSPECTOR, BN5555 • MECHANICAL INSPECTOR, BN5555 • COASTAL CONSTRUCTION INSPECTOR, BN5555 • STANDARD BUILDING PLANS EXAMINER, PX2764 • MECHANICAL PLANS EXAMINER, PX2764 • STANDARD 1 & 2 FAMILY DWELLING PLANS, SFP243 • CERTIFIED FLOOD PLAIN MANAGER, US-16-09103 Ron DeSantis, Governor Julie I. Brown, Secretary STATE OF FLORIDA DEPARTMENT OF BUSINES5'AND PROFESSIONAL REGULATIONS BUILDING CO®E Ab! NW.RATQ.Rt &INSPECTOR LICENSE NUMBER: BN5555 ORATION DATE: NOVEMBER 30, 2023 THE STANDARD INSPECTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 468, FLORIDA STATUTES PETERSON, JOHN CARL 2300 VIRGINIA AVE FORT PIERCE FL 34982 I "e Fr ISSUED: 09/07/2023 Always verify licenses online at MyFlotidaticense.com Do not, alter this document In any form. This is your license. It is unlawful for anyone other than the licensee to use this document Ron DeSantis, Governor Julie I. Brown, Secretary .STAT;E OF FLOP�DA DEPARTMENT OF BUSINESS'ANO PROFESSIONAL REGULATION BUILDINGCODE.Ab`,; I . - IkAT01i-4INSPECTOR LICENSE NUMBER: RPX243 EXPIRATION DATE: NOVEMBER 30, 2023 THE STANDARD RESIDENTIAL PLANS EXAMINER HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 468, FLOItiDA STATUTES PETERSON. JOHN CARL 4404 ARECA PALM DRIVE FORT PIERCE FL 34982 Always verify_. licenses online at MyFjondaWfWmecwn ISSUED: 09/07/2021 Do notafber this document iri any'form, This is your license. it is unlawful for anyoneother than the licensee to use this document Ron DeSantis, Governor Julie I. Brown, Secretary STATE OF, PLOMPI k DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING COD9.AI I@QRIIPrkATOfi$-,* INSPEcrOR LICENSE NUMBER: PX27644 EXPIRATION DATE: NOVEMBER 30, 2023 THE STANDARD PLANS EXAMINER HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 468, FLOIdPA STATUTES PETERSON, JOHN CARL 4404 ARECA PALM DRIVE FORT PIERCE FL 34982 ISSUED:09/07/2021 Always verify licenses online at MyFforidaUcense com Do not after this document in any form. William NlcColman Inspector William has 35 years of experience in inspections and construction management. His areas of expertise include High Velocity Hurricane Zone construction in Dade, Broward, and Palm Beach Counties; estimating; and coordinating trades, materials, quality control, and completion of projects in a timely manner. He is a licensed Florida General Contractor, Home Inspector, and All Lines Adjuster. William's activities within the industry include serving as an active member on the Board of Directors of the National Association of Home Builders Non -Union Apprenticeship program. He was also appointed by the Broward County School Board's Vocational Technical and Adult Education Director to the Advisory Committee for the Southeast Florida Builders Apprenticeship program; served on the Broward County Apprenticeship Craft Committee; and served on the Board of Rules and Appeals and Planning and Zoning Board in the Township of Ocean Ridge, Palm Beach County for five years. PROJECT EXPERIENCE Track Development Homes Various locations, Florida William has provided services for companies such as Oriole Homes, Cadillac Fairview, Lennar Homes, Heffler Homes, and GL Homes. Spec Home Construction Ocean Ridge, West Palm Beach, and Boca Raton, Florida William has worked from design to finish on $1M+ homes. Also conducted remodeling work on historic homes and for general remodels from $50K to $50KOK. Commercial Project History Various Locations, Florida William has completed six Marriott and Fairfield Inn.Hotels in Broward and Palm Beach counties; schools including The Benjamin Upper School in Palm Beach County; and office buildings for companies such as Weitz Construction and Presidential Construction. City of Ft. Lauderdale, Prospect Avenue Water Plant Ft Lauderdale, Florida William completed the major renovation and addition for water plant on Prospect Avenue. Ron DeSantis, Governor Julie I. Brown, Secretary • STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADI!II;NISTRAORS &INSPECTOR THE STANDARD=INSPECTORH'EREiN$IS; CERTIFIED UNDER THE PROVISiONSYOrF�CHAPTER�4'68; FL'O,RIDASTATUTES .: Mc, ffi LMAN 1 VfLLIAMr E; t 8�. SE FL'INTLOCK`tROAD LICENSE: NUMBER: 0,N7752 EXPIRATION DATE:- NOVEMBER 30, 2023 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. ■ This is your license. It is unlawful for anyone other than the licensee to use this document. LOCATIONS A Universal Engineering Sciences Company Geotechnical Engineering I Construction Materials Testing and Inspections Building Code Compliance I Environmental, Health &safety I Facilities Consulting DONALD GREEN Atlanta, GA Hagerstown, MD Pensacola, FL Buford, GA Irvine, CA Port St Lucie, FL Chardllfy, VA Jacksonville, FL Reno, NV Charlotte, NC Kennesaw, GA Rockledge, FL Clewiston, FL Las Vegas, NV Sarasota, FL Daytona, FL Miami, FL St. Petersburg, FL Delray Beach, FL Ocala, FL Tampa, FL Douglasville, GA Orlando. FL Tifton, GA Fort Myers, FL Palm Coast, FL West Palm Beach, FL Fort Pierce. FL Panama City, FL Gainesville, FL Pelham, AL Building Inspector YEARS OF EXPERIENCE 45 SUMMARY OF QUALIFICATIONS Donald Green is a Building Inspector for GFA's Port St. Lucie branch who specializes in YEARS WITH THE FIRM Electrical Inspections. Mr. Green brings over forty-five years of experience in the <1 construction industry. He has vast experience providing services on projects from custom homes to high rise apartment buildings, marinas, and boatyards. EDUCATION HIGH SCHOOL DIPLOMA SELECT PROJECT EXPERIENCE City of West Palm Beach Building Permit Inspections and Plan Review — West Palm LICENSES & Beach, FL CERTIFICATIONS Electrical Inspector • FLORIDA ELECTRICALINSPECTOR, BN7301 As part of a continuing contract, GFA provides the City of West Palm Beach with . INSPECT ELECTRICAL licensed inspectors and plans examiners on an as -needed basis to provide CONTRACTOR, RICAL 7447 supplemental services for various projects located within the City of West Palm Beach. Mr. Green has provided slab inspections on a 30-story high rise multi -use building as well as final fire alarm inspections for the City. - Village of Indiantown Annual Contract for Uniform Building Code Inspection Services — Indiantown, FL Electrical Inspector As part of a continuing contract, GFA provides the Village of Indiantown with Building Official, Building Inspections, Plan Review, and Permitting services on an as -needed basis to provide supplemental services for various projects located within the Village of Indiantown. Mr. Green has provided various electrical inspections for projects located within the Village. Palm Beach County Continuing Contract for Building Inspection, Plan Review, and Permit Technician Services — Palm Beach County, FL Electrical Inspector As part of a continuing contract, GFA provides Palm Beach County with Building Inspectors, Plans Examiners, and Permit Technicians on an as -needed basis to provide supplemental services for various projects located within Palm Beach County. Mr. Green has provided Electrical Inspections for various projects under this contract. This includes slabs, TUG meter, electrical rough, LV rough, electrical power on and final, generator installations, pool bonds, and final pool alarms. STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! V;I, STATE OF FLORIDA DEPARTMENT dprbdOF BUSINESS REGULATION AND PROFESSIONAL SN7301 ISSUED:09/28/2021 STANDARD INSPECTOR GREEN, DONALD BARRY Signatbfe LICENSED UNDER CHAPTER 468, FLORIDA STATUTES EXPIRATION DATE: NOVEMBER 30, 2023 Ron DeSantis, Governor Julie I. Brown, Secretary STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS & INSPECTOR LICENSE NUMBER: BN7301 EXPIRATION DATE: NOVEMBER 30, 2023 THE STANDARD INSPECTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 468, FLORIDA STATUTES GREEN, DONALD BARRY 1305 WEST 1 ST STREET FORT PIERCE FL 34982 ISSUED: 09/28/2021 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This Is your license. It is unlawful for anyone other than the licensee to use this document. GFA INTERNATIONAL, INC. 607 Northwest Commodity Cove Port St. Lucie, Florida 34986 Phone: (772) 489-9989 Fax: (772) 489-2989 TeamGFA.com Pv 14�t11AT1®� JUAN HERNANDEZ, P.E. Professional Registrations Mechanical Inspector • STATE OF FLORIDA Mr. Hernandez is a State of Florida registered professional PROFESSIONAL ENGINEER engineer who specializes in Mechanical Engineering. He has #52659 over twenty years of experience with Mechanical Engineering. Mr. Hernandez currently performs Mechanical Inspections for GFA International, Inc. Select Project Experience TOWN OF JUPITER BLD001-2013/DG PLAN REVIEW, INSPECTION SERVICES AND PERMIT TECHNICIANS • JUPITER, FL • Mr. Hernandez is responsible for providing the Town of Jupiter with Plan Review and Building Inspection services on an as -needed basis for various projects within the Town of Jupiter. CITY OF FORT PIERCE PLANS REVIEW AND INSPECTIONS a FT. PIERCE, FL Mr. Hernandez is responsible for providing plan reviewer and building inspections services to the City of Fort Pierce on an as needed basis for various projects within the City of Fort Pierce. VILLAGE OF INDIANTOWN • INDIANTOWN, FL • Mr. Hernandez is responsible for providing plan reviewer and building inspections services to the Village of Indiantown on an as needed basis for various projects within the Village of Indiantown. OCEANSIDE RESORT • INDIANTOWN, FL • This project consisted of renovations to two existing four-story buildings and a new, two-story addition totaling approximately 198,886-square feet. GFA provided Private Provider Inspections services for building, gas, electrical, plumbing, and mechanical disciplines for the renovation areas and new construction. GFA International, Inc. www.TeamGFA.com June 26, 2019 39 Ron DeSands, Governor STATE OF FLORIDA BOARD OF P THE PROFESS PROVISK M ENGINEERS ED UNDER THE A TATUTES EXPIRATION DATE: FEBRUARY 28, 2023 Always verify licenses online at MyFloridal-icense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. FBPE FLORIDA BOARD OF PROFESSIONAL ENGINEERS STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! duprF�da STATE OF FLORIDA DEPARTMENT OF BUSINESS REGULATION AND PROFESSIONAL BN7601 ISSUED:09/09/2021 STANDARD INSPECTOR DESENTZ, PAUL CHRISTOPHER gnatur LICENSED UNDER CHAPTER 468 RIDA STATUTES EXPIRATION DATE: NOVEMB 0, 2023 Ron DeSands, Governor Julie I. Brown, Secretary STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BUILDING CODE ADMINISTRATORS & INSPECTOR LICENSE NUMBER: BN7601 EXPIRATION DATE: NOVEMBER 30, 2023 THE STANDARD INSPECTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 468, FLORIDA STATUTES DESENTZ, PAUL CHRISTOPHER 1673 SW HAMPSHIRE LN • PORT ST LUCIE FL 34953 Y Y ISSUED: 09/09/2021 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. GFA INTERNATIONAL, INC. 607 Northwest Commodity Cove Port St. Lucie, Florida 34986 Phone: (772) 489-9989 Fax: (772) 489-2989 TeamGFA.com RICHARD JEFFERSON Building Inspector/Plans Examiner i Mr. Jefferson has over thirty-eight (38) years of experience in the ' building inspections and plan review industry. He has served as a building inspector, plans examiner, and building official for many building departments throughout the state of Florida and has a comprehensive understanding and knowledge of the most recent s ` technical building codes and has ample experience performing field inspections, plans review, and building code administrative services on many high rise threshold buildings, as well as municipal and special inspection projects. Select Project Experience CITY OF FORT PIERCE PLAN REVIEW AND INSPECTION SERVICES a FT. PIERCE, FL Education B.S., ELECTRICAL ENGINEERING, UNIVERSITY OF TEXAS Professional Registrations • STANDARD INSPECTOR, BN1164 • BUILDING INSPECTOR, BN1164 • COMMERCIAL ELECTRIC, BN1164 • MECHANICAL INSPECTOR, BN1164 • PLUMBING INSPECTOR, BN1164 • RESIDENTIAL ELECTRIC, BN1164 • ELECTRIC PLANS EXAMINER, PX513 • BUILDING CODE ADMINISTATOR, BU1368 • Mr. Jefferson is responsible for providing the City of Fort Pierce with Plan Review and • MODULAR 1 & 2 BUILDING CODE Inspection services on an as -needed basis for various projects located within the City of Fort ADMINISTRATOR, BU 1368 Pierce. CITY OF SEBASTIAN PLAN REVIEW & INSPECTIONS • SEBASTIAN, FL • Mr. Jefferson is responsible for providing the City of Sebastian with Plan Review and Inspection services on an as -needed basis for various projects within the City of Sebastian. CITY OF ALTAMONTE SPRINGS BUILDING INSPECTIONS AND PLAN REVIEW SERVICES • ALTAMONTE SPRINGS, FL • Mr. Jefferson is responsible for providing the City of Altamonte Springs with Plan Review and Inspection services on an as -needed basis for various projects within the City of Altamonte Springs. JOHNS ISLAND CLUBHOUSE a INDIAN RIVER SHORES, FL This project consisted of the renovation and addition to the existing Johns Island Clubhouse located in Indian River Shores, Florida. Mr. Jefferson performed private provider and threshold inspections for building, electrical, mechanical, plumbing, and gas components. INDIAN RIVER MEDICAL CENTER CANCER CENTER . VERO BEACH, FL • This project consisted of the new construction of a two-story expansion to the existing cancer center located at Indian River Medical Center in Vero Beach, Florida. The footprint area is approximately 14,000-square feet with a second story of about 10,000-square feet. Mr. Jefferson performed special inspections for concrete work, reinforcing steel, fabricated structural steel, welding, anchor bolts, high strength bolting, structural masonry, expansion type anchors, adhesive type anchor bolts, and compacted fill. GFA International, Inc. www.TeamGFA.com June 26, 2019 25 twn Minlis, Gomor STATE OF FLORIDA !edit I. stowm, kcaewf dbpr JMAMA ENTOFBUSINESSAND PR4FESSIONAI REGULATIOPI BUILDING CODE THE 5T, e� Isr. � *1 F3+. 1 ♦•n t H IN, V F 1:111'r & INSPECTOR JD UNDER THE i'aTUTES EXPIRMION DATE; NOVEMBER 30, 2023 lays verity licenses online at Myl'lorldkense com 1 Do not alter this document In any form. This is your license. It is unlawful f+or anyone other than the licensee to use this document. ■I Clyde L. Thirbenny, RIV, PX Inspector Clyde serves as a licensed inspector for GFA/UES' Port St. Lucie branch,with more than a decade of industry experience. He offers a wealth of knowledge to the team with qualifications encompassing building inspections and plans examination (including zoning). His expertise ranges from residential inspections to municipal efforts. He is well -versed in code compliance with FBC, state, local, ADA and city codeson new and existing structures. PROJECT EXPERIENCE GFA International, Inc. - Inspector/Plans Examiner 2021-present Port St. Lucie, FL Mr. Thirbenny currently serves as the Port St. Lucie location of GFA/UES. Currently, he performs building inspections and plans reviews as needed. Municipal Support: Code Compliance Stuart, FL GFA/UES currently holds a contract with the City of Stuart to provide municipal support. As an assigned inspector, Mr. Thirbenny performs inspections across various locations. Sovana Stuart Senior Housing: Threshold Inspections Stuart, FL GFA/UES is engaged as a threshold inspection consultant for the Sovana Stuart Senior Housing community. Mr. Thirbenny performs inspections as needed for this opportunity. Building Inspections/Evaluations - Maltz Jupiter Theatre Jupiter, FL GFA/UES' Port St. Lucie branch is engaged as a building inspection consultant for the Maltz Theatre in Jupiter, Florida. Mr. Thirbenny performs inspections as needed for this opportunity. Threshold Inspections - Florida Power & Light PGA Office Complex Palm Beach Gardens, FL GFA/UES'Port St. Lucie branch performed threshold inspections for Florida Power & Light's Office Complex in Palm Beach Gardens, Florida. Mr. Thirbenny served as inspector for this opportunity. i Ron DeSantis, Governor Julie 1. Brown, Secretary ItIlo• . �^ Y �- dupr: -�STATE OF • • . . DEPARTMENT OF . PROFESSIONAL BUILDING CODE, RS & INSPECTOR THE STANDARD •*4' IFIED UNDER THE PROVISIOtl TUTES k a s it Tom• .. rf EXPIRATION • A { ]+Y A �' onlineAlways verify licenses MYF[oridaLicense.com f � � I 7iii1 • notalterdocument in anyform. ti• �r n fThis is yourfor . other than the licensee to use this • . STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! STAT— tOF'FLORIpA DEPARTMENT d 1prF rida OF BUSINESS AND' PROFESSIONAL i REGULATGION PX1847 ISSUE6:08/31/2021 STAN DA RD. P,LAN S; EXAMINER THIRBENNY; CLYDE: ' LICENSED UNDER CHAPTER 468;TLOM)A STATUTES EXPIRATION DATE: NOVEMBER, 30;-2023 Ron DeSantis, Governor Julie I. Brown, Secretary STATE OF FLORIDA. DEPARTMENT OF BUSINESS AND PR0FES510NAL REGULATION BUILDING `CODE ADMINISTRATORS i&;INSP,ECTOR LICENSE NUMBER: PX1847 x EXPIRATION DATE: NOVEMBER 30, 2023 THE STANDARD PLANS EXAM INER-HEREIN;IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 461 , FLORIDA STATUTES k THIRBENNY, CLYDE 5388 EADIE PL WEST PALM BEACH FL 33407 ISSUED: 08/31/2021 Always verify licenses online at MyFloridaUcerise.com Do not alter this. document in anyform. This is your license. It is unlawful for anyone -other than the licensee to use this document. Raymond Oscar Gendron Inspector/Plans Examiner PROJECT EXPERIENCE Senior inspector/Plans Examiner Aspen, Colorado Senior inspector/Plans Examiner Hobe Sound, Florida inspector/Plans Examiner Stuart, Florida Inspector/Plans Examiner for the Martin County Building Department. Ron DeSailtis, Gc, err. , Julie I. Brown, Secretary db�opiq-�- .:;.j;TATE OF FLORIDA Ir4kbbANU PROFESSIONAL REGULATION ADMINISTRATORS & INSPECTOR TH:' f..*; CHAP, FL 'ORWASTATUTES TER 468, ELEC,,':B-.LLD G-. RESI, W 14 11!ji -MONDrOSS CAR 'P.0-*.-BOX 593, FL'33-475- '.)i,13E`56UNO :C-ENSENUMBER: SN4955 r I :! � " - ION DATE: NOVEMBER 30,2023 L 1 . I :icenses online at MyFloridaLicense.com .:it alter this document in any form. is yo,ir This i-i '::v -ul for anyone other than the licensee to use this document.