1723 E Park Ter PPRI20-0002 PP Final Inspection ReportL E G A C Y
1 INC OFFICIAL USE ONLY
6415 Meenland R. -d
jacksonAle. FL 32258 Rcc0-.vd Oat.:
vD4.721.1100 Received ey-
Itvat iv CZaality —orar= office
INSP'tt` i IUMS LER i IFIED By PRIVA I E PROVIDER
PRlval E PFru-vi DER 119FORIOIAI ION I FPROJECT INFORMATION
Name of Firm: Legacy Engineering. Inc.
Primary ContaUt: _John Ellis
Phone #: 9.721-1100
Interim RevaFt ❑ Final Report xi
All Interim and Final Reports Mus-, N Signed ana ztealea
CER I IPICFi C;N
Permit Dumber: TPL< w _Ccov
Address: [1',3 Park Wrr F -
Owner: V/t1 n1'1
e �4�
+,
ConzraRor: l t lYJ
In accordance with Florida StatUte 3)3.,7i and the requirements establishes by thejurisaaiction , mis is to
celtiry that I or my approves duly autliorizea representative pertormei# all tRe inst crtions listen Belo.:, aha ecrtiry
that the work inspected was according to the Florida Building Code. Further, I, including my employees, agents, and
sub -consultants, shall hold harmless, and indemnify the City, its directors, officers, employees, representatives, anaa
agents against any claim, actlon_ loss, tlamage, in;ary Iialility, ev3t, aria a --pease of-Ratsoever Rana or nc.tare
(includinisr but not by way of imitation, attorney's fees and court costs) arise out of injury (whether mental or
corporeal) to persons, including death, or damage to property, arising out of or incidental to me, my employees,
agents, ano /or sun -consultants Tor worn peRormea Rere.naer inciaaing, oat not limitea to all omission. o.-
vorrections to documents. i Fl,s indemnification agreement is separate and apart from and in noway limited by, any
insurance provided in pursuant to this agreement or otherwise.
I also eonfiTm tRot all monie3 Have beer, raid to me in full for these professional services. Should additional
Inspe-ions be required of me by the because of errors or omissions on my part, there will be no
addltlonal charges for these services to tRe
I further confirm that no individual, corvvration, partnership, joint venture or other legal entity, or any employee
thereof that Ras provillee any part o► tRis inspecVp%A vice, Ras 'hat! any part in Me vesign, permitting, or Ras any
o-n=r3Rip intere.,t of 5Fy Kina in tFie aboveN �tf9fRr�,�t�
�v GE_ �''��'49
(Signature of Private Provider)
-o STAT E OF
(Private Providerzea l)
[i�I a�CC IR�PELI IOI4a PeRF�Rl9lEl7 —H[tacM?irs it necessary
PERRni I I TPE PERMli I MCIMISEtt DHF E IiaZPE�1101a CCIVE PiRD
PERFORIgIED DESCRIP I IUN
alalaA 10111! OF PERa0111
CER I Yt-YING INbPECTION
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