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• • Pasco County Building Construction Services <br /> Contractor Licensing <br /> 8731 Citizens Drive, Suite 230 <br /> j New Port Richey, FL 34654 <br /> (727) 847-8009 <br /> • Email: contractorlicensing@pascocountyfl.net <br /> CONTRACTOR AUTHORIZATION FORM <br /> STATE LICENSE NO.: CCC1329562 <br /> PRINT QUALIFIER'S NAME: Hugh Macdonald <br /> BUSINESS NAME: Alvarez Roofing <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 /> Melinda Hegarty <br /> Lois Larsen <br /> Erin McCamant <br /> Jim Coston <br /> Signature of Qualifier: '( Date: <br /> E39&01m <br /> l WRIAM 1 CHOROIdCOMMISSION#FF942182PIRES February05.2020FbridAl�loranserv�.co,r <br /> State of Florida <br /> County of Pasco `� ! <br /> Sworn to and subscribed before this day <br /> Notary Public State of Florida <br /> (Stamp) <br /> My commission expires Q )94,16 <br /> g/devsvcsdocuments\1-documentspecialists\bcslbcsformslContractor Authorization Form Revised 4/3/17 <br />