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Alternative Service --Agreement
Project: DR Horton-Creekside'- 3456 Trinity Circle.• Fort Pierce, FL 34945=Lot 20
Private Provider Firm: Universal Engineering Sciences-.: -
Private Provider Name: John'Carl Peterson-
Address:- 607 Commodity, Cove. Port SCLucie::FL 34986 .
Phone:: (772).-924-3575 Fax:.(772) 924-3580
Names, License/Certificate Numbers,-and'L•iicense 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• and2:family),.-Plumbing:- -
aosean 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. -
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. Ifurtheragree 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,.yo ill be ified in i immediately..
Representative Name:
Signature
State of Florda,'County.of Palm Beach, n n /� ` p �,
Sworn to' (or affirmed) and subscribed before me.this `� `7 day of /"1 , 2021, by., y. '' ! �-� �
who is personally known to me.
r ( ?.fir IS
Printed. name of tary:. Signature of,N, a
Notary Public,Stamp:
� i'±u' ,•. BRITTOW LYNN JOZAIT15
Notary'pubdc • State of Florida
CoMmission 0 PJ* 106A55.
'fig. n My Co—JXpires Mar 21-. 2025
3ereee : re�4r 4adenai Nctary.assr: