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HomeMy WebLinkAboutAlternative Service AgreementPqUNIVERSAL® ENGINEERING SCIENCES Grounded in Excellence Geotechnical Engineering Construction Materials Testing & Inspection Building Code Compliance Occupational Health & Safety Environmental Building Envelope Alternative Service Agreement Project: DR Horton-Creekside — 3304 Homestead Drive , Fort Pierce, FL 34945-Lot 96 Private Provider Firm: Universal Engineerinq 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 I 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 personnel shout change, or if any person listed above should discontinue to quality as a duly authorized agent, you will be notified in�g imme-diately Representative Name: Signature State of Florida, County of Palm Beach, Sworn to (or affirmed) and subscribed before me this day of(I , 2021, by John who is personally known to me. Printed name of No ary Notary Public Stamp: 4}Pr Pu"-" BRITTANY LYNN jo2Arr15 ?� Ni Notary Public • State of Florida .`9 Commission # HH 106455 My Corr. Ex;l•es ua• 21. 2025 Signature of Notary