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Alternative Service Agreement
Project: -DR Horton-Creekside--3448 Trinity Circle,. Fort Pierce, FL 34945=Lot 22. .."
Private Provider Firm: Universal Engineering Sciences .. .'
Private Provider Name: John Carl Peterson .
-Address:.607.Coriom6dity Cove, PortSt::Lucie,:FL 34986 .
Phone: (772)"924-3575' ' 'Fax: (712) 924-3580 -
Names, License/Certificate Numbers, and License description of provider and. -duly authorized :agents.who will be
proyiding services for this project:
Name:. :.
LicenseLCertificate No::
License/Certificate. Type: :.
Matthew -Chaney
BN#:7342.'.".'Inspector=.Building,.
-.Don Determan.._ .
BN# 4688
Inspe6tor,=:Building-(1'and 2 family),"PIumbiri
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 forthis 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 that if for any reason -the inspection personnel should change; "or-if'any- listed above -should. discontinue,
to quality as a:duly authorized agent, you will.be notified ' writin medi
Representative Name:
Signature
nature
State of Florida, County -of Palm, Beach,
AeSworn to (or affirmed).and subscribed'before me. this—1 day of :J .1:�, 2021, by �'�
who is personally known to me.
Prin ed ame of -Not" ry:. :_ ignature of Notary .
Notary Public.Stamp:. :.,
AM,
a" BRRTANVLVNN:02ARIc.
IZNo
cary.Pubdc - State of Ficride
Commisslbn ? �F 1Q6aer
,•?r!�.••- My Comm. Expires Mar 2:: 2:25 - .. .. .. .
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