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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 46
Sheets: - C1, CN Al A2C, EL P1. ML Di. D22, WA1 WA2, WA2, WA6. S1. SLIA. S1.2. S1 2A 2, S21A,
S3, SMA, S3.1B, S3.1C, SNl, PAl
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 Sta ute of holds the appropriate license
or certificate.
Richard Olds
PX 2178 Signature: Date: Ic
Plans Examiner
Richard Hoaalin
PE 48796 Signature, / 1 M ho�
Private Provider
State of Florid
COUNTY of 8ave'a
SW RN AND SUBSCRIBED before me on the o`` day of O(.%` b24 , 20�'"
by V ;rkVot %being personally known to me and who, being fully sworn and cautioned,
state that the foregohig is true and correct to the best of his/her knowledge of belief.
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SIJAature o Nota Print Name:
Notary Public Expires:
Notary Stamp: JenWw tw=FuhW
°1 A ° Notary Public
-state of Florida
CommgHH035937
.ONCE 1% Expires 8/24/2024