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Alternative Service Agreement
Project: ' DR Horton-Creekside- 9608 Potomac Drive., Fort Pierce, FL 34945-Lot 123
Private Provider Firm: Universal Engineering Sciences-..'.
Private Provider Name: John'Carl Peterson
Address:.607 Commoditv'Cove, PortSt.:Lucie::FL 34986 .
Phone: (772): 924-3575 � Fax: .(7.72),924-3580 .
Names, License/Certificate Numbers, and'License description of 'provider and: duly authorized:agents.who will be
providing services:foe this project.
Narne:. ;. _
' License/Certificate No::. -
License/Certificate:Type:. ;
Matthew Chane y , ;
BN#:7342 �_ .. � ::. ; . :...Inspector;—
Building,.
Don Determan . .
"BN#4688 ::
Inspector.=:Builditig.,(1 and 2:family),-Plumbing.
Josean Duprey.' ':
BN#:7330
'Inspector -'.Building..
_Carl Peterson .
BN# 5555 RPX# 2.43 : :
Inspector."WEP,,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;'PlumbingMechanical.'
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 personnefshould change; or. if any person listed above should discontinue to quality as a duly authorized agent, you will,be notifie riting im ediate
. p %7 A.
Representative Name:
State of Florida, County of Palm Beach,
Sworn to (or affirmed) and subscribed before me this 2 day of r l 2021, by e ► Q
who is personally known to me.
L, Joz0,Ifi5
Printed. name of N ary. Signature of No
Notary Public Stamp:
i�;, ORMAN" VNIN;OUITIS
/S4ykr Notary PubdC • State of Florida
Commission a uH 106455
My Comr. Expires Mar 21. 2025
3creee :rrcugr vae.erai Nctarn Assr.