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Alternative Service Agreement
Project: 'DR-Horton-Creekside- 9304 Potomac Drive., Fort Pierce, FL•34945-Lot 106
Private Provider Firm:' .Universal Engineering Sciences ..
Private Provider Name:. John Carl Peterson -
Address:. 607 Commodity Cove. Port St:: Lucie, A 34986 .
Phone:-(772).924-3575 F6x:'.(772) 924-3580
-Names, License/Certificate Numbers, • and Licensee -description of :provider and duly authorized:agents.Who will be
providing services'foethis project:
Name:.. :.
-'LicenseLCeetificate' No::.•
License/Certificate Type'
yp. :.
Matthew•Chaney
BN#:7342 '... :• : -- �.'
..lnspector- Building..
Don Determan."..
' BN# 4688 • :", :
Inspector.-•Building:.(1�and 2:family),-Plumbing', -
Josean Duprey .. ':: ':..
BN#.7330 ': ; - •
'Inspect Buildin g..
Carl Peterson .., .
•BN# 5555 RPX#.243
Inspector.= MEP, Building,
Michael Benton.-
...
BN#;8067
. , .
'Inspector- Inspector -Building (land? family);
Mechanical, Plumbing,
-Donald- Green
BN#7301
Inspector -Electrical
yincent Burdo :". :.
.BN#5337
Inspector -Electrical,: Rlumbing Mechanical.
As"the.private•inspection services provider for this project, I have;read and agree to be,bound tdthe 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 in wr' ' immediately..
Representative Name:
Signature.
State'of Florida, County of Palm. Beach,
2ci r9 J. i9�+e.�s
Sworn to (or affirmed) :and subscribed before me. is .. day of : ..pal 2021, by Q n . .
who is personally known to. me..
Printed: name of otary . gnature of N
Notary Public.Stamp:.
f ;u�•, EAfr.TANVLYNNJ02AMS
`F Notary OUbdC - 5Tate of Florida
VCommission s Hi. 106455 .
My Comm. E*fres Mir 21, 2025
3eneee +rp %aticrartieraryAsir.