HomeMy WebLinkAboutAlternative Service Agreement® Geotechnicat�_ gineerifig
U N I V �E R S A L Construction Materials Testing & Insprection
:. ENGINEERING SCIENCES :.
Building Code Compliance
Occupational Health &Safety.
Enviro.nrnental •
Grounded -in Exellence,. Build(ng.Envelope_. .
Alternative: Service Agreement
Project: DR Horton-Creekside-�3457 Trinity Circle.. Fort Pierce, FL 34945=Lot .1
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 provided and:duly autliorized: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 .'.: ..'Inspecfor=.Buildin
9.
Carl Peterson .', . : ..
`BN# 5555 RPX#.243 = :
lnspedtor.=:MEP, Building.
Michael. Benton
... , .. ..
BN# 8067
.. • ..
Inspector- Inspector=Building (1 and 2 family);
..
Mechanical, : .
cal, Plumbing.
Donald`Green
BN07301 .
Inspector -Electrical
:Vincent Burdo :.
BN#5337
..Inspector-Electrical,:'Plumbing Mechanical.-
i4s the private inspection services provider for this project, I have:read and agree to be bound tothe 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 in wifing i edict ,
Representative Name:
Signature
State of Florida, County; of Palm. Beach,
Sworn to (or affirrried).and subscribed before me this `? . day of % 1: 2021, by �1 ��l� Jon
who ispersonally known to me.
{.. .
-Printed:'name of.Notary:' Signature of Nota
gV
Notary Public Stamp:
;iy.It�`�•• BRIttaNY LVNN JOZAinS
+F`Ft Notary Public'- State of Florida .
Commission I HH 106455
My Comm, Expires Ar 21, 2025
9anaee tnrour,, National Notary Assn;