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2093 Beach Ave PPRI22-0001 - COC from LegacyLEGACY ENGINEERING, INC. 6415 Greenland Road Jacksonville, FL 32258 INSPECTIONS CERTIFIED BY PRIVATE PROVIDER OFFICIAL USE ONLY Recieved Date: Received By: Route To Quality Assurance Office PRIVATE PROVIDER INFORMATION PROJECT INFORMATION Name of Firm: Legacy Engineering Permit Number: PPRI22-0001 Primary Contact: John Ellis III Address: 2093 Beach Ave Phone #: 904-721-1100 Atlantice Beach, FL 32233 Interim Report Final Report: El Owner: Contractor: Alsech Contracting All Interim and Final Reports Must Be Signed and Sealed CERTIFICATION 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�Rawin'the*.sign, permitting, or has any ownership interest of any kind in the above referenced project. � SW01�Ty% LEIIS134, - (Signature of Private Provider) A(Private Provider Sea!) 4 ,. ` LIST ALL INSPECTIONS PERFORMED - Attached additional page�'if necessary DATE INSPECTION CODE AND SIGNATURE OF PERSON PERMIT TYPE PERMIT NUMBER PERFORMED DESCRIPTION CERTYFYING INSPECTION Bldg PPRI22-0001 4/14/2022 Window Door Rough Michael Howard Bldg PPRI22-0001 4/14/2022 Partial Framing Michael Howard Bldg PPRI22-0001 4/14/2022 Lathing Michael Howard Bldg PPRI22-0001 4/21/2022 Lathing Michael Howard Elec ERE22-0117 5/24/2022 Rough Electrical John Ellis Mach GSRS22-0028 5/24/2022 Rough Mechanical John Ellis Revised 2/5/2018 PERMIT TYPE PERMIT NUMBER DATE PERFORMED INSPECTION CODE AND DESCRIPTION SIGNATURE OF THE PERSON CERTIFYING INSPECTION Bldg PPRI22-0001 4/21/2022 Lathe Michael Howard Elec ERE22-0117 5/24/2022 Rough Electrical John Ellis Mech GSRS22-0028 5/24/2022 Rough Mechanical John Ellis Plumb GSRS22-0028 5/26/2022 Plumbing Rough John Ellis Bldg PPRI22-0001 5/26/2022 Insulation Michael Howard Elec ERE22-0117 6/3/2022 Electrical Cover up John Ellis Plumb 6/3/2022 Plumbing Top Out John Ellis Bldg PPRI22-0001 6/3/2022 Framing Michael Howard Meth GSRS22-0028 6/3/2022 Range Hood Fire Suppression John Ellis Bldg PPRI22-0001 6/7/2022 Insulation Michael Howard Bldg PPRI22-0001 7/12/2022 Exterior Lath Michael Howard Elec ERE22-0117 8/4/2022 Temp Power John Ellis Bldg PPRI22-0001 4/24/2023 Wall Sheathing Mark Belton Bldg PPRI22-0001 4/24/2023 Window Flashing Mark Belton Bldg PPRI22-0001 1/23/2024 Building Final Mark Belton Plumb 1/23/2024 Plumbing Final Mark Belton Mech GSRS22-0028 1/23/2024 Mechanical Final Mark Belton Elec ERE22-0117 1/23/2024 Electrical Final Mark Belton