HomeMy WebLinkAboutAlternative Service AgreementGeotechnicat Engineering
[PUNIVERSALO Construction Materials Testing & Inspection
ENGINEERING 'SCIENCES
Building- ode Compliance
occupationai-Health & Safety
Ehvifanmental
GroUhded in Eiccellenc'e.. Buildi.ng.EnVelope.. .
Alternative Service Agreement
Project: DR Horton-Creekside- 3408 Trinity Circle,Tort Pierce, FL 34945=Lot 32 .
Private Provider Firm: Universal En-gineering Sciences ..
Private Provider Name: John Carl Peterson -
Address:. 607 -ComrTiodity Cove. Port St..Lucie,:FL34986 .
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.
Pon Determan = : ;-
BN# 4688
Inspe6tor.'=:Bui1ding,-(1 and 219mily),. 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 .
Inspector -Electrical
;Vincent Burdo ;, : •
BN#5337 :
"Inspector -Electrical, Plumbing Mechanical.
P P J
As the private _inspection services roylder for this ro'ect, 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 noiifieditin�yimmedely.
Representative Name:
Signature
State of Florida, County, of Palm Beach,
Sworn to (or affirmed) and subscribed before me this 2`7 . day of l7 �rI I , 20 1, by �.:•
2
'who is personally known to me.
RnfCc(� Jozolf(s
Printed: name of Not ry:. , Signature of Notary
Notary Public Stamp:
3NGEarY
NV LVNN :&Florida
S.
ublic • Stat
`Cg7ission 0 hl. Expirei M025
3crr ratlerai ss.-.