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U N 1 V ER S A L: Construction Material's Testing & Inspection
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ilding Code Compliance
ecupational Health & Safety-
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Grounded in 6xcellerace... Bui{dng.Envelope, .
Alternative Service -Agreement
Project: DR-Horton-Creekside- 3440 Trinity Circle,. Fort Pierce, FL'34945=Lot 24
Private Provider Firm: Universal Engineering Sciences-...
Private Provider Name:. John'Carl Peterson -
Address:. 607 Commodity. Cove, Port SL.Lucie,:FL 34986 . -
Phone: (712).-924-3575 Fax:.(772) 924-3580
Names, License/Certificate Numbers; and L'icense,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,
DonDeterman_.. -
BN#4688 .,
.Inspector.=.Build ing..(1'and.2:family), Plumbing:'.
JoseanDuprey,: `::
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.-ffurther.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 notifie writing im diatel i
Representative Name:
Signature
State of Florida, County, of Palm'Beach,
Sworn to (or affirmed) and.subscribed_ before me this of �1: 1'1 2021; by V.
who. ispersonally known to me.,
Printed: name. of Notary:' nature of Notary '
Notary Public Stamp:
y J'a •, BRITTAw LYNN JOZA.11
Notary Pubdc w State of Florida
i `= Commission ;: Hh 106AS5
,.
••...ov , ,.% - My Comm. Expires ivar 21. 202'
9encee ;areugn raricra, ae;aty assr.