HomeMy WebLinkAboutAlternative Service Agreement® Geot�, .,r.4calEngineering . .
U� N 1 V E I SAIL construction Materials Testing & Inspection
EN.GINEE.RING SCIENCES
Building Code Compliance
Occupational Health & Safety.
:. Environmental
Grounded in Excellen6e Building Envelope .
Alternative: Service Agreement
Project: DR Horton-Creekside- 9624 Potomac Drive., Fort Pierce, .FL 34945=Lot 127..
Private Provider Firm: Universal Engineering Sciences'
Private Provider Name: John Carl Peterson -
Address:. 607 Commodity- Cove, PortSt..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 -
.. Inspecfor _ Building,.
Don Determan „ .
BN# 4688 _ :.
Jnspector.= Building,.(1.'and 219mily),-Plumbing:-
Joseph Duprey. ,
BN#:7330 :: :.:Inspector:-.Buildin
9 ..
Carl Peterson .
'BN# 5555 RPX#243
Inspector=:MEP,'Building.
Michael Benton
BN#:8067
Inspector- Inspector -Building (4 and 2 family),'
Mechanic.
al, Plumbing—,
.Donald`Green.
BN#7301
InsPector=Electrical
:Vincent Burdo : ,
BN#5337
:'Inspector=Electrical,:'Plumbing Mechanical:
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. I 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 should change; or -if any person listed above should discontinue- - _ to quality as a:duly authorized agent, you will.be notified ' riting i diatel
AOOOP
Representative Name:.
Signature
State of Florida, County of Palm Beach, �]
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.Sworn to (or affirmed).and subscribed before me this . -/. day of .���� I , 2021, by J 'Pe+��
who ispersonally known to me.
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rinted:name of Nota y: - Signature of Notary
Notary Public.Stamp:
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BRIT70v LYNN ;OUTIS
Notary
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Public- Sta-e of Florida
CO;nMIssion 4 -F 106AS5
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