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15-16193
Zephyrhills
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2015
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15-16193
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Last modified
3/21/2016 2:53:13 PM
Creation date
3/21/2016 2:53:12 PM
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Building Department
Company Name
FLORIDA HOSIPTAL
Building Department - Doc Type
Permit
Permit #
15-16193
Building Department - Name
PEACEFUL SPRINGS LLC
Address
37924 MEDICAL ARTS CT
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PLEASE PRINT ON YOUR COMPANY LETTER�AD <br /> Let�er ofA�thoriz��io�t <br /> Project Name: <br /> Project Location: <br /> Pemut Issuing Agency: <br /> I, � � �� � 1 M� ,property owner of the above noted property do hereby authorize <br /> Printed Name <br /> The Sign Resource,Inc and/or any authorized representative of The Sign Resource,Inc to submit for and receive SignBuilding <br /> pernuts and related electrical permits as required for new signage at the above-noted property.Furthermore,any authorized <br /> representative of The Sib Resource Inc may sign documents required to obtain such permits in my stead. <br /> The authority provided above is strictly related to the pernuts outlined above and such authority shall cease immediately upon <br /> approved final inspections for the project described above.Additionally,the authority provided above is not relevant to any other <br /> prcject or�atter w-iu�out a separate and aduitionai Leiter oi Autnorization document being provided. <br /> I have placed my notarized signature or mark below to allow such authorization. <br /> Property Owner/Authorized Representative Signature � Title �}r� <br /> Property Owner Address: ��C,��yi �r��� �..,�5 c�(/i� ' '�- '��i'��T L ����'� <br /> 1 � <br /> Properry Owner Phone:S-;•�T���� c3 ;� Property Owner Facsimile: <br /> The foregoing instrument was acknowledged before me on the��day of � �I��t�� .2oi� <br /> by �T�(�1��h, M .�• .who is personally known to me/who provided <br /> as identification and who did/did not take an oath. <br /> �,,, <br /> State of ;��h�; gE�g,�,q� <br /> ?r; ,r MY OOARA9ISSION A EE 159234 <br /> Coun Of �� � �P��S:Jenuaty 11,2016 <br /> t3' •�fTf,tk� Banded Thru Nohry PubBc Undeiv�s <br /> l��P�l1�. �)• /I.c�.(����� �v�-% Notary Stamp/Seal <br /> Notary 3'gnat�ye <br />
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