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ENGINEERING SCI'ENCfS
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Geot�rc,i�,Jcal Engineering
Construction Materiats Testing &'Inspection
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Environmental
Building Envelope, .
Alternative Service Agreement
Project: ' DR Horton-Creekside- 3423 Trinity Circle.. Fort Pierce, FL 34945-Lot 87 .
Private Provider Firm: Universal Engineering Sciences.... .
Private Provider Name: John Carl Peterson- .
Address:. 607 Commodity Cove, Port St. Lucie. fL 34986 .
Phone: (772) 924-3575 Fax:.(772) 924-3580 . .
Names, License%Certificate Numbers, and License 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# 7342Inspector
= Building :
Don Determari -_- ''
' BN# 4688
Inspector._ Building (1-and 2'family),-Plumbing`
Josean Duprey
BN#:7330 ....
Inspector- Building
Carl Peterson
BN# 5555 RPX# 2.43
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 furtheragree 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 inning i'ediately�. .
Representative Name: ./2&4
Signature
State of Florida, County of Palm Beach,
Sworn to (or affirmed) and subscribed before me this . day of .4p n2021, by J peecn
who is personally known to
r �n u dam .4 es
Printed: name of tary
Notary Public Stamp:
BRIT TIO V44 .QZAIT15
Nctary Pubic • state of Florida
F:
Commission: nF 106,25!
MV Comr-.'Expires Mer 21, 2025
?CrCet :n. CL%r Nat,'Crar NOtAry ASSr.