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f , <br /> SIGNATURE AUTHORIZATION FORM <br /> FOR THE PURPOSE OF <br /> OBTAINING BUILDING PERMIT <br /> Date el", <br /> I, fro m AAONV6 46-k'_C-�,-41A e. <br /> authorize 0 to sign for me in order to obtain <br /> building permit(s) under my business or contractor's license <br /> # CIS <br /> This authorization is NOT limited to a specific job location and address. <br /> City of Zephyrhills <br /> Job location: ALL PERMITS OBTAINED IN THE CITY OF ZEPHYHILLS BUILDING <br /> DEPARTMENT <br /> I understand that this authorization letter must be revoked in writing <br /> 16A-Aes 9W�1 <br /> Contractor-Printed Name <br /> Contractor- Signature <br /> State of Florida// <br /> County of V(CV0 <br /> The foregoing instrument was acknowledged before me this �—l� day of <br /> 11C-r, 20 by e &OA .t K who is perso ally known to me or <br /> who h s produced as identification. <br /> pS�Y Aue(i NIKOLE DIAZ <br /> ' o Commission*G G 013209 Not ry Public <br /> sr a� Expires July 19,2020 <br /> 9T`°OF f�O� 6c^,Cc�Ttru&4gat Wt yS,-M <br />