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Alternative Service Agreement
Project: DR Horton-Creekside = 9519 Potomac Drive, Fort Pierce, FL 34945-Lot 1.6
Private Provider Firm: Universal Engineering Sciences "
Private Provider Name: John Carl Peterson -
Address:. 607 Commodity. Cove, Port St.. Lucie,:FL 34986.
..
hone: (772) 924-3575' Fax:1772) 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/Ce'rtifcate,Type
MaftheW-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
lnspector-Electrical
Vincent Burdo '.
BN#5337
Inspector-Electrical,'Plumbing Mechanical,
;As the private inspection services provider foe this project, I have:read and agree to be.bound to the provisions of State.
Statute'553.791., Vfurther=agree and understand that only the above listed personnel may: perform.. inspections oii.this
project. and that if for any reason the inspection personnel' should change; or -if anyperson listed above -should discontinue=--
to quality as.a duly 'authorized agent, you will be no d in writing imme ' ly: .
Representative Name:
a - : Signure t
State of Florida, County of Palm. Beach,
Sworn to (or affirmed).and subscribed before me this .. day of _ ICI d.. 202.1, by
who is personally known to. me. .
40r) jT U U.
Printed: name of N tary:. ignature of Notary
Notary Public.Stamp:
` BRPTANV LYNN JOZAmJ
Notary Public • State of Flo
Commission 0 HH 106a5
My Comm; Expires Mar 21, Uneec,�rcugr'kae.crai Notary