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HomeMy WebLinkAboutAlternative Service AgreementMUNIVELSAL ENGINEERING SCIENCES Grounded in Excellence Gec" °nical Engineering Con. lion Materials Testing & Inspection Building Code Compliance Occupational Health & Safety Environmental Building Envelope Alternative Service Agreement Project: DR Horton-Creekside — 9609 Potomac Drive, Fort Pierce, FL 34945-Lot 18 Private Provider Firm: Universal Engineering 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 inspection person 1 should change, or if any person listed above should discontinue to quality as a duly authorized agent, you will be nqW in imm�rliately. Representative Name: Signature State of Florida, County of Palm Beach, Sworn to (or affirmed) and subscribed before me this ;�3 day of 2021, by John ee11!>ry0r who is personally known to me. q1_1++0()C4 L, JOW1+0 Printed name of Notary Notary Public Stamp: f�yiy••. BRITTANY LYNN JOZAITIS �t Notary Public • State of Florida .� Commission d HH 106455 �.� My Comin2025 g. Expires Mar 21, Assn. 9ercec ;rreu h National Notary (/�; e -;� P_ � �/- - ) Signature of I I96 // -