HomeMy WebLinkAboutPrivate Provider Plan Compliance AffidavituN1V-m"RSAL®
ENGINEERiNO SCIENCES
DR Horton-Creekside
California Model -Lot 113
9412 Potomac Drive
Fort Pierce, FL
Private Provider
Plan Compliance Affidavit
California Model-9412 Potomac Drive
Private Provider Firm: Universal Engineering Sciences
Private Provider: John Carl Peterson
Address: 607 NW Commodity Cove, Port St. Lucie, Florida 34986
Phone: 772-924-3575
Fax: 772-924-3580
Email: jeterson(c universalengineering.com
I hereby certify that to the best of my knowledge and belief the plans submitted were
reviewed for and are in compliance with the Florida Building Code and 'aft 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: John Carl Peterson Revised Plan Sheets: C-1, GN, Al, A2, El, P1, Ml, Dl, D2,
WA1, WA2, WA3, WA6, S1, Sl.lA, S1.2, S2, S2.1A, S2.2A, S3, S3.lA, S3.1B, S3.1C,
SN1
Florida License/Registration/Certification #(s) and description:
John Carl Peterson
RPX 243
Signature of Reviewer:
SWORN AND SUBSCRIBED befor me by John Carl Peterson, BU 1721
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.
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Signature of Notary Print Name
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