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HomeMy WebLinkAboutPrivate Provider Plans Compliance AffidavitPrivate Provider Plans Compliance Affidavit Permit # Private Provider Firm: GFA International Private Provider: Richard Jefferson Address: 607 NW Commodity Cove Phone #: 772-924-3575 Applicant: Century Complete Applicants Fax #: I hereby certify that to the best of my knowledge and belief the plans submitted were reviewed for and are in compliance wit 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 Project: 7008 Plumosa Lane Plan Sheets: GRP2 0.2, GRP2 0.4, GR132 1.0, GR132 1.2, GR132 2.3, GRP2 3.3 Florida License/Registration/Certification #(s) and description: Signature of Private Provider: SWORN AND SUBSCRIBED before me by _ �- 1 Cxow& -Te'f P oyl being personally known to me or having produced as identification and who being fully sworn and cautioned, state that the foregoing is true and correct to the best of his/her knowledge or belief. S% m. rw 4'.- Signature of Notary Notary Public: Notary Stamp Below My Commission expires: 0611U22 S�DI,"m IM G l,c.�raU Print name Private Provider Plans Compliance Affidavit Permit # Private Provider Firm: GFA International Private Provider: Richard Jefferson Address: 607 NW Commodity Cove Phone #: 772-924-3575 Applicant: Century Complete Applicants Fax #: I hereby certify that to the best of my knowledge and belief the plans submitted were reviewed for and are in compliance wit 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 Project: 7008 Plumosa Lane Plan Sheets: GRP2 4.0, GRP2 4.3, GRP2 5.1, GRP2 6.2,SO.0, S1.0B, S1.1B Florida License/Registration/Certification #(s) and description: BU #1368 Signature of Private Provider: SWORN AND SUBSCRIBED before me by Il-V Cka Y- t Je-4CfS& being personally known to me 1/ or having produced as identification and who being fully sworn and cautioned, state that the foregoing is true and correct to the best of his/her knowledge or belief. S Signature of Notary Notary Public: Notary Stamp Below My Commission expires: n 111 12uh23 svlaArwh M6A Print name Private Provider Plans Compliance Affidavit Permit # Private Provider Firm: GFA International Private Provider: Richard Jefferson Address: 607 NW Commodity Cove Phone #: 772-924-3575 Applicant: Century Complete Applicants Fax #: I hereby certify that to the best of my knowledge and belief the plans submitted were reviewed for and are in compliance wit 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 Project: 7008 Plumose Lane Plan Sheets: S2.013, SD1.0, SD2.0, FD1.0, 0-1, NOA's, Energy CaIcs_ Florida License/Registration/Certification #(s) and description: BU #1368 Signature of Private Provider: SWORN AND SUBSCRIBED before me by gJCk0J— a4et0h being personally known to me or having produced as identification and who being fully sworn and cautioned, state that the foregoing is true and correct to the best of his/her knowledge or belief. 5V&"IPIA, YVIO Signature of Notary Notary Public: Notary Stamp Below My Commission expires: ZdZ3 %V "J%1 Print name