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Alternative Service Agreement
Project: ' DR Horton-Creekside- 9600 Potomac Drive, Fort Pierce, .FL 34945=Lot 121. -
Private Provider Firm: Universal Engineering Sciences
Private Provider Name: John Carl Peterson .
Address:. 607 Commodity Cove, Port• St.. Lucie; :FL 34986 .
Phone: (772).9243575" - Fax:.(772) 924-3580
Names,- License%Certificate Numbers, and'L•icense 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#:7342 , ...
Inspector:- Building,.
Don Determan.'., .
BN# 4688
Inspector.= Bui1ding•.(1 and 2 family),. -Plumbing'.
aosean Duprey.. ' :
BN#:7330
Inspector;= Building •'
Carl Peterson'. .
BN# 5555 RPX#.243 :
.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,; 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. 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 personnel should change; or if any person listed above should:discontinue = to quality as a duly authorized agent, you will -be notif writi imme
Representative Name:.'
.. Signatu
re
State of Florida, County. of Palm:Beach,
Sworn to (or affirmed).and subscribed before me. this `7 .'day 2021, by
who is personally known to me. -
Printed:name of N tary Signature of Notary
Notary Public. Stamp:..
�'.4�•Y BRITTANV LYNN j&AffI$ -
Noury-public • e of Fiorfda
" Commission 0 Pf 1 or
y Comm, Expires Mar 21. 202!
3or.CEC':rooQr VarVar roiary Ass,-.