HomeMy WebLinkAboutAlternative Service Agreementy—.
-Geotechnicat -Engineering
Construction Material's Testing & Inspection
Building Code compliance
Occupational Health & Safety
Environmental
Building. Envelope.,
Alternative Service Agreement
Project: ' DR-Horton-Creekside- 3412 Trinity Circle...Fort Pierce, FL 34945=Lot 31
Private Provider Firm: Universal Engineering Sciences'
..
Private Provider Name: John Carl Peterson -
Address:. 607 CommoditvCove. PortSt..Lucie,TL'34986 .
Phone:'(772)'924-3575 Fax:.(772) 924-3580
Names, License/Certificate Numbers; and Licensedescriptionof provider and:duly authorized agents who will be
providing services for this project: _
Name:. °.
' License/CertificateNo::.
License/Certifici te,'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." MEP,•Building:. .
Michael Benton
BN# 8067
.. -
Inspector- Inspector -Building (1 •and 2 family),
Mechanical, Plumbing..
Donald Green -
BN#7301
InspectoroElectrical
Vincent Burdo '.
BN#5337
Inspector,=Electrical,. Plumbing Mechanical
Dan Divan:.
BN#4041 ::
Inspector -Building, Plumbing, Mechanical.".
Richard 'Schofield :.
BN#2710
Inspector -Residential
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, orif•any'person listed above should.discontinue'
to quality as a.duly authorized agent,.you will,be ed in citing i m lately:
Representative Name:
Signature
State of Florida, County of Palm Beach, .
Sworn to (or affirmed).and.subscribed before me thisday of 2021, by v 42, n
who is personally known to me.
00*
. Jo
Printed: name of „ otary: Signature of Nota
Notary Public.Stamp:
�r BRI TANV LYNN JOLtIt
1 Notary PgbifC • State of i
'd! Commission a Ni+ 1064My CommExpires MZi%atiom1 wctar