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19-22174
Zephyrhills
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2019
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19-22174
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Last modified
2/18/2021 10:55:16 AM
Creation date
2/17/2021 10:47:15 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
19-22174
Building Department - Name
FERGUSON,PHYLLIS
Address
4830 17TH ST
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` boidr5ull <br /> � To whom itmyconcern, <br /> } <br /> / \ dO hereby aUthOhze the following names listed below to as my <br /> agents ip submitting permits applications and obtaining permits for in <br /> � . <br /> | addition tn register with the jurisdiction and renew registration. Under license number EC13008840. <br /> A <br /> M] �=� / <br /> ^^� / � = <br /> \ �\ <br /> / r^� <br /> Signature of Owner <br /> Print Name ofOvv.ner/Depresentative <br /> Title <br /> Sworn and subscribed to before methis DL day of by <br /> vvhois/arepecsonaUyknowntpnneorhas/have-rmduced as identification. <br /> ! Persona|}yKnovxny�lOR Produced |6ent�cat|on [ lType of identification Produced <br /> . <br /> (Signature of Notary Public-State ofFlorida) <br /> (Print/TYpe, ) <br /> E4N:Not"=� -=~~ <br />
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