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Alternative Service Agreement
Project: Cristelle Cav Condos-4804 Ocean Palms Drive North Hutchinson Island, Fort Pierce, FL 34949
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:
Kevin Hempel
BN#2335
Inspector- 1 & 2 Family, Building, Mechanical,
Electrical, Plumbing
Don Determan
BN# 4688
Inspector — Building (1 and 2 family), Plumbing
Josean Duprey
BN# 7330
Inspector - Building
Vincent Burdo
BN#5337
Inspector -Mechanical, Electrical, Plumbing
John Carl Peterson
BN# 5555, BU#1712
Inspector — Building (1 and 2 Family) Mechanical,
Raymond Gendron
BN# 4955
Inspector- Inspector -Building (1 and 2 family),
Electrical
Clyde Thirbenny
BN#4046
Inspector -Building, Mechanical, Plumbing
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 authorizecj,�gen&�y_ou will_# pAtified in writing immediately.
Representative Name: ""
Signature
State of Florida, County of Palm Beach, II T
Sworn to (or affirmed) and subscribed before me this `i day of 0 C+O )QQ y 2021, by n C t(SGp
who is personally known to me.
J4&�ti y, fvrL
Printed name of Notary Sign a of Notary
Notary Public Stamp:
iii:::
NESSA YVME FUNES
.4y Public - State of Florida
i mmission N HH 130136
mm. Expires May16,2025
ough National Notary Assn.