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17-18379
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2017
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17-18379
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Last modified
12/19/2017 9:53:59 AM
Creation date
12/19/2017 9:53:59 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
17-18379
Building Department - Name
SHUTT,RAYMOND & JEANNE
Address
5531 18TH ST
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A OLD TIME ROOFING 2636 22ND Street North <br /> • ' St. Petersburg, FI 33713 <br /> '��� �� ------ (727) 824-9996 <br /> r.r.r�r. <br /> �r,r� ,� _ - =-_____ Lic. #CCC1327304 <br /> � ��, �` ��=�i. <br /> APRIL 20, 2017 <br /> CITY OF ZEPHRHILLS <br /> Buildin�q Division Construction Permit <br /> 5335 8 " STREET � <br /> ZEPHRHILLS, FLORIDA 33542 <br /> I, BLAKE BURNSIDE, QUALIFIER FOR "A OLD TIME ROOFING, INC." HOLDING <br /> FLORIDA STATE LICENSE # CCC1327304, GIVE MY PERMISSION FOR THE <br /> FOLLOWING PERSONS TO REGISTER, SIGN, OBTAIN AND PICK UP PERMITS <br /> FOR"A OLD TIME ROOFING INC." <br /> MARK SMALL - FOR THE DATE OF APRIL 20T" 2017 ONLY � <br /> SINCERELY, <br /> KE BURNSIDE <br /> QUALIFIER <br /> BEFORE ME PERSONALLY APPEARED BLAKE BURNSIDE TO ME KNOWN TO <br /> BE THE PERSON DESCRIBED IN AND WHO EXECUTED THE FOREGOING <br /> INSTRUMENT FOR THE PURPOSE THEREIN EXPRESSED. <br /> TN SS: M HAND AND OFFICIAL SEAL THIS�DAY OF I� 20 j 7 <br /> �'� `� - <br /> MY COMMISSION EXPIRES � � � <br /> NOTARY PUBLI , STATE OF FLORIDA <br /> o��'�;�uei, PATHICIA V.LIPE <br /> r o <br /> ,� �t,� * MY"COMMISSION#GG 033245 <br /> �"y�`��oe EXPIRES:September25,2D20 <br /> lFOR F�d�' eone�d T�ru Budpet Natory Semc� <br />
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