HomeMy WebLinkAboutASA - Creekside Lot 21 signed.pdf®UNIVERSAL®
ENGINEERING SCIENCES
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Building Envelope
Alternative Service Agreement
Project: DR Horton — Creekside —3452 Trinity Circle Fort Pierce FL 34945 - Lot 21
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, Plumbin
Dan Divan
BN# 4041
Inspector — Building Plumbing. Mechanical
Richard Schofield
BN# 2710
Inspector — Residential
Ra mond Gendron 1
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 if for any reason the inspection personnel should change, or if any person listed above should discontinue
to quality as a duly authorized jKnt, you will be l Aified in writing immediately.
Representative Name:
State of Florida, County of Palm Beach,
Signature
Sworn to (or affirmed) and subscribed before me this -t day of 7S2021, by �
who is personally known to me.
v�l'S
Lq(,u
Printed name of Notary
Notary Public Stamp:
LINAMAR!ASIFUENTES
' Commission # GG 262173
Expires September 25, 2022
.•�`q °`` Bonded Thm Troy Fain Insurance 800-385-7019
Signature of Notary