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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 45
Sheets: Cl, GN, Al, A2C, El. P1, M1, D1, D2, WAl, WA2, WA2, WA6. S1, S1.1A, S1.2, S1.2A, S2, S2.1A,
S3, SMA, S3.1B, 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 tatute of holds the appropriate license
or certificate.
Richard Olds �1
PX 2178 Signatur Date: C `'�/
Plans Examiner
Richard Hoacilin v Qz)-)
PE 48796 Signature: ate:
Private Provider
State of Florida
COUNTY of
SW RN AND SUBSCRIBED before me on the9�" 1 �day of �1 V�KJ�' , 20�---
by��'C being personally known to me and who being fully sworn and cautioned,
state that the foregoMg is true and correct to the best of his/her knowledge of belief.
61'�_
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4"+'ture ry Print Name:
Notary Public Expires:
Notary Stamp: gat
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SCE
Notary Public
`�-State of Florida
yComm# HH035937
� Expires 8124/2024