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1 <br /> , , '� <br /> TESLA ELECTRIC SERVICES INC. <br /> 111 N. BAYSHORE BLVD UNIT C4 <br /> CLEARWATER FL 33759 <br /> CONTRACTOR AUTHOIRIZATION FORM <br /> STATE LICENSE# EC 13005478 <br /> PRINT QUALIFIERS NAME: NCJCYC`� � rJ� C�� <br /> BUSINESS NAME �5�r� ��2c����C S��v�ce5 -��C, <br /> *I authorize the following individuals to sign for and obtain permits at City of <br /> Zephyrhills Building Department <br /> , <br /> Print ,�►aS L , r�.G-e� Sigr��� ������ <br /> Signature of Qualifier date � � - � <br /> State of Florida <br /> COunty Of� � �t�5��rpu'�� <br /> Sworn to and subscribed before this date ��r�� L, 6 �O I � <br /> ,,,,,,,,, <br /> ;�.�""p�e�c; JAIRO GARCIA ROOR(Q11E2 '' <br /> � . s Nolary Publlc-St�te ot Flafd� <br /> ' Commlaslon#�Ff 23�113 " tary Public State of Flori a <br /> �'►���n ..� My Comm..ExplrAs M�y 2S�20 <br /> (stamp <br /> My commission expires � - 2�s=�) �' <br />� <br />