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Private Provider Plans Compliance Affidavit
Private Provider Firm: Universal Engineering Sciences
Private Provider:
Richard Hoaglin 820
Address:
Brevard Ave,
Rockledge, FL 32955
Phone:
321-638-0808
Fax:
321-638-0978
Email:
RHoaglin@universalengineering.com
Project Name: DR Horton, Creekside Plat 4, Lot 38
Sheets: - CI,GN.AlA2C, F1, P1, Mt, D1 D2, WAL WA2, WA2, WA6,S1, SLIA, SI.2, S1,2A, 2, S2.1A,
S3, SMA, SIM, S3.1C, SNl, PA1
hereby certify that to the best of my knowledge, information, and belief he reference plans
submitted were reviewed for, and are in compliance with, the Florida Building Code and all local
amendments to the 2017 Florida Building Code by the following affiant, who is duly authorized to
perform plans review pursuant to Section 553.791, Florida Statute of holds the appropriate license
or certificate.
Richard Olds
PX 2178 Signature: Dater
Plans Examiner
Richard Hoacilin
PE 48796 Signature:
Private Provider
Date:
State of Florida
COUNTY of ` X-eve ri
SVVQRN AND S BSCRIBED before me on the M41 day ofJf' , 20SZ56
byKVGWV 6 tbtU, being personally known to me and who being fully sworn and cautioned,
state that the foregoing Is true and correct to the best of his/her knowledge of belief.
SWfiature of 06tary U Print Name:
Notary Public Expires:
Notary Stamp: JennlrerJ=MFuhW
t �s
Notary Public
0 —State of Florida
r Comm# HHD35937
f�NCE A EXpIMS 8/ 0024