HomeMy WebLinkAboutAlternative Service Agreement�eotechnicalEngineering
WJ.U.NJV:k:RS,AL@'Wuction Materials Testing• & •Inspection
:. EN:GINEERING SCIENCES
Building Code Compliance
Oct;uPati:onal Health &Safety
`Environmental
GroUnded in Exce'llencie', - Buiddi.ng.EnVelope,.
Alt.erna.tive Service Agreern'en't
Project: DR Horton-Creekside- 3428 Trinity Circle.. Fort Pierce, FL 34945=Lot 27 .
Private Provider Firm: .lJniversal Engineering Sciences
Private Provider Name: John Carl Peterson
-Address:. 607.Commodity Cove. -Port St.. Lucie, fL 34986 .
Phone: (772).924-3575 Fax:4772) 924-3580
Names; Licens6/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 Chane y :.
BN#:7342
..Inspector _Building,' :. ..
Don Determan. ,' .
BN# 4688 : ', : :". _
Inspector.=:Building ._(1 and 2:family),-Plumbing:'
Joseari Duprey.,.'
BN#:7330 ":' .. _ : ""
:Inspector =Building
-Carl Peterson .'
''BN# 5555 RPX#2.43
inspector.=:MEP, Building.
Michael Benton
BN#.8067
'Inspector- Inspector -Building (Land 2 family)'' .
Mechanical, 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 i pffing im diately.
Representative Name:
`Signature.
State of Florida, County, of Palm. Beach,
fec�_Or)
.Sworn to (or affirmed)'and subscribed' before me this .. day of 2021, bye/.•.
who is personally known Wine.
Printed name of otary.. Signature of Notary
Notary Public Stamp:
�►r v •• - BRrrrANV LYNN:JOZAITIS
Notary public - State of NoNda
Commission d �+ 106451
oCn "'"my Comm. Expires Mar 21.2025
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