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16-17424
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2016
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16-17424
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Last modified
11/1/2016 11:48:43 AM
Creation date
11/1/2016 11:48:43 AM
Metadata
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Building Department
Company Name
MOORES FIRST ADDITION
Building Department - Doc Type
Permit
Permit #
16-17424
Building Department - Name
PANZER,FRANCIS W & EVELYN
Address
4928 18TH ST
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, � � � <br /> ., _ - :F <br /> -. ,, s.._. „:�'_ �ve.a.✓.f�;;.;�"' r::�_„ ,. <br /> ..-r-.�.<.v m-�;•".''�.<i«;asrt:=.'��, ._,5,.,, e � <br /> �:,r� IIl���s <br /> � �. -�:� ;������-. �:_. <br /> �- .� . :_ =�;���� -- � :�o�r -I��_ <br /> ���`� ' I 3e:ati-� �8�;Air::Conditionin:g <br /> �:���;>w _. .. . . �,.. -.. <br /> .. , r. _._ .� ... ...,:.::�- � ,;?. r.,�-,-:�. :-:,A•�- r <br /> 3:5= �ears'`-:of-Quzilzty Ser�ice <br /> Authorized Agent Affidavit <br /> I, Carlos Martinez of McWilliams and Son Inc hereby grant authorization to Gilbert McWilliams <br /> Jr to act in my behalf with any City or County in the State of Florida as acting agent with no <br /> restrictions for the Building Division. These activities specifically include signing all documents <br /> requiring signature of"contractor" and is to be considered an agent of my business, and <br /> therefore, the signature of said agent is binding and causes me to assume all responsibilities <br /> connected to or associated with the signature as they may relate to my contracting business. As <br /> said contractor, I also agree to relieve the City or County from, any and all responsibility, claims <br /> or other actions arising from or related to the Building Division's acceptance of the above <br /> agent's signature for permit related activities. I further understand that it is my sole responsibility <br /> to grant and terminate any such authorization and to ensure that the Building Division receives <br /> timely notice of any such grant or termination. <br /> ,����� ��i��°�' - � <br /> Signature of C ntractor/Qualifier's Name Signature of Acting Agent <br /> License Number: EC13007378 <br /> Nota for Contractor Si nature <br /> State of Florida County of � ���� <br /> The foregoing was acknowledged before me this��day of �I IuU ,2016 by <br /> ����_,who is personally known to me or who produced ��as identification. <br /> MARIA VITIELLO <br /> :°`�'Y�U�� MY COMMISSION#FF958783 <br /> Notary Stamp: �� IXPIRES:FEB 09�2020 <br /> Notary Pu lic Sig a re � Bonded through 1et Steta In�ut�noe <br /> Notarv for Authorized A�ent ' , <br /> State of Florida County of <br /> T e foregoing was acknowledged before me this 3r� da of�— 1 b <br /> � ' ho is personally known to me or who p oduced " ��� y as identification. <br /> � Notary Stamp: �,�,� MARIAVITIELLO <br /> ota u licSignature s° �o MYCOMMISSION#FF958783 <br /> EXPIRES:FEB 09,2020 <br /> °j`"� Bonded through tst State Insurance <br />
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