HomeMy WebLinkAboutASA- Creekside Lot 43- Signed.pdfiEngineering
®UNIVERSALConstruction
Materials Testing &Inspection
ENGINEERING SCIENCES Building Code Compliance
Occupational Health & Safety
Environmental
Grounded in Excellence Building Envelope
Alternative Service Agreement
Project: DR Horton — Creekside — 3318 Trinity Circle Fort Pierce, FL 34945 - Lot 43
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 — Building (1 and 2 Family ), Mechanical
Michael Benton
BN# 8067
Inspector- Inspector -Building (1 and 2 family),
Mechanical, Plumbing
Donald Green
BN# 7301
Inspector -Electrical
Vincent Burdo
BN# 5337
Inspector -Mechanical, Electrical, Plumbing
Dan Divan
BN# 4041
Inspector — Building Plumbing. Mechanical
Richard Schofield
BN# 2710
Inspector — Residential
Raymond Gendron
BN # 4950
Inspector - Building 1 and 2 family), Electrical
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 H for any reason the inspection personnel should change, or if any person listed above should discontinue
to quality as a duly authorizeo.,�rgent,you will tg notified in writing immediately.
Representative Name:
State of Florida, County of Palm Beach,
Sworn to (or affirmed) and subscribed before me thise—day of �t 1 Cle 2021, by-,
who is personally known to me.
P' —
anted name of Notary Signature of Notary
Notary Public Stamp:
;W✓%^!y '. LINAMARIASIFUENTES
Comm scion # GG 252173
pp; Expires September 25, 2022
+•,oirv�+' Bonded ThuTmy FA inswaKa 800.885.7019