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16800 Okeechobee Road
Ft. Pierce, FL 34945
Private Provider
Plan Compliance Affidavit
A2P0090A — TMO Anchor
Private Provider Firm: GFA International, Inc.
Private Provider: Thomas Montano, P.E. 84146
Address: 607 NW Commodity Cove, Port St. Lucie, Florida 34986
Phone: 772-924-3575 Fax: 772-924-3580
Email: tmontano@teamgfa.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: Richard Jefferson Plan Sheets: (8) - Master Set: T-1. G-1, C-1, C-2, C-3 E-1
E-2, E-3, (1-35) - Structural Analysis
Florida License/Registration/Certification #(s) and description:
Josean Duprey ` ` tj e
PX4208 ���' ?6 ''
Signature of Private Provider:
SWORN AND SUBSCRIBEI&fore nATE OF
being personally known to me �' V4Z 6r 1 %t -j
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that the foregoing is true and correct to itht;ib¢sael
Signature of Notary
Notary Public: NOTARY STAMP BE OW
My commission expires:
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Thomas Dominic Montano
P.E. No. 84146
Dominic Montano, P.E. 84146
1 -as identification
swom and cautioned, state
knowledge or belief.
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