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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 81
Sheets: C1, GN, Al, A2C, EL P1, MI, DI, D2, WA1, WA2, WA2, WA6, SL SLIA. S1.2, S1.2A. S2, S2.1A,
S3, SMA, SIM, S3.1C, SN1, 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 St ute of holds the appropriate license
or certificate.
Richard Olds "&Z>0
PX 2178 Signature: Date:
Plans Examiner •
Richard Hoaglin
PE 48796 Signature: te: f
Private Provider
State of Florida
COUNTY of&Ct -"
SWORN ANDS BSCP'IBED before me on the day of ff-, 20�
being personally known to me and who being fully sworn and cautioned,
state that the foreg ' g is true d correct to the best of his/her knowledge of belief.
Si ature of N tary Print Name:
Notary Public Expires:
Notary Stam�R JennbrJearnafthrer
Notary Public
z c State of Florida
= Comm# HH035937
EA Expires 8/24/2024