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16-17123
Zephyrhills
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Building Department
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2016
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16-17123
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Last modified
2/20/2017 10:39:40 AM
Creation date
2/20/2017 10:37:23 AM
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Building Department
Company Name
ZEPHYR BREEZE
Building Department - Doc Type
Permit
Permit #
16-17123
Building Department - Name
BOOMHOWER,GORDON & CARLENE
Address
6131 19TH ST
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� <br /> SUB-CONTRACTOR AFFIDAVIT � <br /> DATE: � f �I� <br /> TO WHOM 1T MAY CONCERN: <br /> I, Thomas Lachance d/b/a Southem Comfort Ent. Inc. <br />, License Number: CAC1813579 will be the Mechanical <br />, contractor for t,�is permit application. <br /> The job address is:�,-y��d�✓c� �O/3% /9�i �5r� Z�,J�i � ✓li�`l5�-L� 3���/ <br /> % <br /> yvL� <br /> S� of Licen.se older or Authorized Agent <br /> STATE OF: FLORIDA <br /> COUN1'Y OF: SiJMTER <br /> I HEREBY CERTIFY that the foregoing instrument was acl�owledged before me this ;� <br /> day of /�'1C�1/'C�► ,20 G by Thomas Lachance ,who is personally l�own to <br /> me.. <br /> � � � I <br /> of Notary lic , i <br /> Prin�Type,or Stamp of Notary <br /> ���ar r�� ' <br /> r : ; � D/If�1�E WAD <br /> 7 * MY COA�IISSION 0 FF 014875 <br /> EXPIRES:August 7,2017 <br /> ���'Fov c�o���e 8�ded ThN Blqpet No!ary Ser�ices <br />
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