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HomeMy WebLinkAboutAlternative Service AgreementU � � � � � � � �® Gee` Ghnical Engineering g p Cc'[,,, -Diction Materials Testin & Inspection ENGINEERING SCIENCES Building Code Compliance Occupational Health & Safety Environmental Grounded in Excellence Building Envelope Alternative Service Agreement Project: DR Horton-Creekside — 3321 Trinity Circle , Fort Pierce, FL 34945-Lot 76 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# 7342 Inspector— Building Don Determan BN# 4688 Inspector — Building (1 and 2 family), Plumbing 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 Dan Divan BN#4041 Inspector -Building, Plumbing, Mechanical Richard Schofield BN#2710 Inspector -Residential 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 personnels uld change, or if any person listed above should discontinue to quality as a duly authorized agent, you will be notified 1p"ing 1vKnqlJiatq1y. /, / Representative Name: r signature State of Florida, County of Palm Beach, /� n j Sworn to (or affirmed) and subscribed before me this �3 day of TT ��1 , 2021, byV M0r who is personally known to me. 1-1-nru 1, . dowlM r ( LITU Printed name of Notary Notary Public Stamp: aira ? • r lei BRITTANV LYNN JOZAMC Notary public - State of Florida Commission 4 HH 106455 My Comm. Expires Afar 21, 2025 So ec :nrcugn •raticnai Nctary Assr., UN1VEr;AL® ENGINEERING 5WENCES DR Horton-Creekside California Model -Lot 76 3321 Trinity Circle Fort Pierce, FL Private Provider Plan Compliance Affidavit California Model-3321 Trinity Circle Private Provider Firm: Universal Engineering Sciences Private Provider: John Carl Peterson Address: 607 NW Commodity Cove, Port St. Lucie, Florida 34986 Phone: 772-924-3575 Fax: 772-924-3580 Email: jeterson(&,universalengineering.com I hereby certify that to the best of my knowledge and belief the plans submitted were reviewed for and are in compliance with the Florida Building Code and all local amendments to the Florida Building Code by the following affiant, who is duly authorized to perform plans review pursuant to Section 553.791, Florida Statute and holds the appropriate license or certificate: Name: John Carl Peterson Revised Plan Sheets: C-1, GN, Al, A2D, El, P1, Ml, D1, D2, WAl, WA2, WA3, WA6, S1, SLIA, S1.2, S1.2A, S2, S2.1A, S2.2A, S3, S3.lA, S3.1B, S3.1C, SN1 Florida License/Registration/Certification #(s) and description: John Carl Peterson RPX 243 Signature of Reviewer SWORN AND SUBSCRIBED before me by John earl Peterson, BU 1721 being personally known tome—)( or having produced as identification and who being fully sworn and cautioned, state that the foregoing is true anorrect to the best of his/her knowledge or belief. Art Honw L. Signature of N y Print Name ^u •, BR"ANV LYNN JOZAMS ('$! Notary Public • State of Florida Commission d NN 10645S My Comm, Expires mar 21.2025 9cneed arougr Aiadcnai "ary Assn.