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HomeMy WebLinkAboutAlternative Services AgreementeotechnicaEngineeringg]UNIVL SAL Materials Testing &Inspection ENGINEERING SCIENCES Building Code Compliance Occupational Health & Safety Environmental Grounded in Excellence Building Envelope Alternative Service Agreement Project: DR Horton-Creekside — 9312 Potomac Drive, Fort Pierce, FL 34945-Lot 108 Private Provider Firm: Universal En-gineering Sciences Private Provider Name: John Carl Peterson Address: 607 Commodity Cove, Port St. Lucie, FL 34986 Phone: (772) 924-3575 Fax: (772) 924-3580 Names, License/Certificate Numbers, and License description of provider and duly authorized agents who will be providing services for this project. Name: License/Certificate No.: License/Certificate Type: Matthew Chaney BN# 7342 Inspector — Building Don Determan BN# 4688 Inspector — Building (1 and 2 family), Plumbing Josean Duprey BN# 7330 Inspector - Building Carl Peterson BN# 5555 RPX# 243 Inspector — MEP, Building Michael Benton BN# 8067 Inspector- Inspector -Building (1 and 2 family), Mechanical, Plumbing Donald Green BN#7301 Inspector -Electrical Vincent Burdo BN#5337 Inspector -Electrical, Plumbing Mechanical Dan Divan BN#4041 Inspector -Building, Plumbing, Mechanical Richard Schofield BN#2710 Inspector -Residential As the private inspection services provider for this project, I have read and agree to be bound to the provisions of State Statute 553.791. 1 further agree and understand that only the above listed personnel may perform inspections on this project and that if for any reason the' spection personnel shoul change, or if any person listed above should discontinue to quality as a duly authorized ag ,you vya4,6,15j�notiiied in)wrli Wediately. Representative Name: Signature State of Florida, County of Palm Beach, Sworn to (or affirmed) and subscribed before me this day of 2021, by 70 - &1- who is personally known to me. Printed name of Notary ����IIIloft"" Notary Public Stamp: �%. % pNL lwgljj"� GEXldi PIR�S VL Z. .� Sept .97 20MI: � ; Q Signature of Notary