HomeMy WebLinkAboutAlternative Service AgreementG eon&.,n, ical'Engineering
U N 1 V E= k S A L Cori§truction Materials Testing & Inspection
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Grounded in Excellepce. :. euildi.ng Envelope-
Alternative Service Agreement
Project: DR •Horton-Creekside- 3424 Trihity-Circle.: Fort Pierce, FL 34945=Lot 28 '
Private Provider Firm: Universal Engineering Sciences • • .
Private Provider Name: John Carl Peterson .
Address:.607-Commodity. Cove, Port St..Lucie::FL 34986 .
Phone:` 77 44 575 ax 7.924-3580.
Names, License/Certificate Numbers, -and License,description of provider and -duly authorized :agents.who will be
providing services for this project.
Name:.. '
' Llcense/Certlficate *No.'::... ;
-License/Ce'rtif cate. Type:
Matthew Chaney ': ::
BN#:7342
pector=Building. .Ins
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 .: '..
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-thatif for any reason the inspection personnel hould change; or if any person listed above -should .discontinue- —
_=--
toquality as a:duly authorized agent, you will be notifiedolm riting i edict
Representative Name:
S ignature
State -of Florida, County. of Palm Beach, j
Sworn to (or affirmed).and subscribed before me this. day of , 2021, byV • t" efe.�
who is. personally known to me.
Griff0tnU . Z41115
Printed: name of -No ary: - ` nature of Notary
Notary Public Stamp:
BRITTAW LYNN ANTIS .
%/••'y�`! Notary Public • State of Florida
.COmMISSion 0 hH 106AS5
oRn My, Comm, Expires Mar 21, 202S
Bcnced :arcugr varcrai Naar., Assn.