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PR <br /> PAINTING/WATERPROOFING <br /> RESTORATION EXPERTS <br /> "We Bring Buildings Back to Litel" _ _- <br /> CONCRETE PAINTING & RESTORATION LLC <br /> I <br /> CONTRACTOR.AUTHORIZATION FORM <br /> STATE LICENSE NO. CGC058385 <br /> I <br /> PRINT QUALIFIER'S.NAME: SCOT BULEY <br /> BUSINESS.NAME: CONCRETE PAINTING AND RESTORATION; I-C <br /> I <br /> *THIS AUTHORIZATION SUPERSEDES ALL PREVIOUS SUBMITTED AUTHORIZATIONS* <br /> I authorize the following individuals to sign for and obtain permits: (Please print names clearly.) <br /> JEREMY DESGAGNE <br /> Signature of ualifier: �� � Date: l0 r� - ' <br /> i <br /> g Q <br /> t. <br /> State of Florida <br /> County of Pasco <br /> Sworn to and subscribed before this day <br /> i <br /> NotaryCPub).)tate of Florida <br /> I. <br /> I <br /> (Stamp) <br /> My commission expires. <br /> I <br /> KRISTA MATUSKY <br /> c-State of Florida. �GV'p� KRISTA MATUSKY <br /> t Co on GG'C�20a ,=i,�:�'. 'Notary Public-State of Florida <br /> [a^'?S�G:2L 2v21 _ ; ` .Commission GG 107204 <br /> r::.aac;ry Asir. •;y = c My Comm.Expires May 22,2021 <br /> I <br /> q. <br /> Bonded through National Notary Assn. - - - <br /> Tampa Bay.Corporate Office radenton/Sarasota Location <br /> 711 Wesley Ave Suite A.,Tarpon Springs, FL 34689 4545 Mariotti Court, Suite B, Sarasota, FL 34233 <br /> Main Line: 727-939-9393,813-512-8060/Fax: 727-286-2938 Main Line:941465-1458 <br /> Licensed&Insured Email:,Donny(a-)cprpaintng.net Website: Cprpainting.net <br />