Laserfiche WebLink
• Pasco County Building Construction Services <br /> e . Contractor Licensing <br /> 8731 Citizens Drive, Suite 230 <br /> = - New Port Richey, FL 34654 <br /> (727) 847-8009 <br /> • ' . Email: contractorlicensing@pascocountyfl.net <br /> CONTRACTOR AUTHORIZATION FORM <br /> STATE LICENSE NO.: CCC 13�73 5 <br /> PRINT QUALIFIER'S NAME: KEN PHA��I Ps <br /> BUSINESS NAME: IST CHOICE Roo Filib we . <br /> *THIS AUTHORIZATION SUPERSEDES ALL PREVIOUS SUBMITTED AUTHORIZATIONS* <br /> authorize the following individuals to sign for and obtain permits: (Please print names clearly.) <br /> _� IIll <br /> �dM KRAFCI ►L. <br /> Signature of Qualifier: 14'2 <br /> Date: L2 L,702 p <br /> State of Florida <br /> County of Pasco �A.�v�� ,,� .2 0 2 b <br /> Sworn to and subscribed before this day <br /> ary Public State of Florida <br /> (Stamp) 4 Notary Public State of FWftdm <br /> My commission expires $ 22 ,?OZ 2 Carl W Jenkins <br /> 0� <br /> My Commission GG 244179 <br /> a Expires 08/22/2022 <br /> g/devsvcsdocuments\1-documentspecialists\bcs\bcsforms\Contractor Authorization Form Revised 4/3/17 <br />