1980 Mipaula Court - COCLEGACY ENGINEERING, INC.
6415 Greenland Road Recieved Date: _________________________
Jacksonville, FL 32258 Received By: ___________________________
INSPECTIONS CERTIFIED BY PRIVATE PROVIDER
Name of Firm: Legacy Engineering Permit Number:
Primary Contact: John Ellis III Address:
Phone #: 904-721-1100
Interim Report Final Report: Owner:
Contractor:
CERTIFICATION
(Signature of Private Provider)(Private Provider Seal)
LIST ALL INSPECTIONS PERFORMED - Attached additional pages if necessary
PERMIT TYPE PERMIT NUMBER DATE
PERFORMED
Building RESA22-0026 3/3/2023 Mark Belton
Building RESA22-0026 3/3/2023 Mark Belton
Building RESA22-0026 3/6/2023 Mark Belton
Building RESA22-0026 3/30/2023 Mark Belton
Plumbing RESA22-0026 3/30/2023 Mark Belton
Building RESA22-0026 4/21/2023 Mark Belton
Revised 2/5/2018
SIGNATURE OF PERSON
CERTYFYING INSPECTION
RESA22-0026
1980 Mipaula Court
Atlantic Beach FL 32233
Alesch Contracting
Roof Deck and Ties
Top out
Window/Door
All Interim and Final Reports Must Be Signed and Sealed
INSPECTION CODE AND
DESCRIPTION
Footing
Roof Nailing
Dry In
OFFICIAL USE ONLY
Route To Quality Assurance Office
In accordance with Florida Statute 553.791 and the requirements established by the City of Atlantic Beach,this is to certify that I or
my approved duly authorized representative performed all the inspections listed below,and certify 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,and agents against any claim,action,loss,damage,injury
liability,cost,and expense of whatsoever kind or nature (including,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,and /or sub-consultants for work performed hereunder including,but not limited to
all omissions or corrections to documents.This indemnification agreement is separate and apart from and in no way limited by,any
insurance provided in pursuant to this agreement or otherwise.
I also confirm that all monies have been paid to me in full for these professional services.Should additional inspections be
required of me by The City of Atlantic Beach because of errors or omissions on my part,there will be no additional charges for these
services to the City of Atlantic Beach.
I further confirm that no individual,corporation,partnership,joint venture or other legal entity,or any employee thereof that has
provided any part of this inspection service,has had any part in the design,permitting,or has any ownership interest of any kind in
the above referenced project.
PRIVATE PROVIDER INFORMATION PROJECT INFORMATION
PERMIT TYPE PERMIT NUMBER DATE
PERFORMED
INSPECTION CODE AND
DESCRIPTION
SIGNATURE OF THE
PERSON
CERTIFYING
INSPECTION
Electrical RESA22-0026 5/5/2023 Electrical Rough Mark Belton
Building RESA22-0026 5/5/2023 Framing Mark Belton
mechanical RESA22-0026 5/5/2023 Mechanical Rough Mark Belton
Building RESA22-0026 10/24/2023 Insulation Mark Belton
Building RESA22-0026 10/26/2023 Building Final Mark Belton
mechanical RESA22-0026 10/26/2023 Mechanical Final Mark Belton
Plumbing RESA22-0026 10/26/2023 Plumbing Final Mark Belton
Electrical RESA22-0026 10/26/2023 Electrical Final Mark Belton