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20-615
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2020
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20-615
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Last modified
2/24/2022 7:57:02 AM
Creation date
2/24/2022 7:57:01 AM
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
20-615
Building Department - Name
RUMFORD,BRETT & TANYA
Address
4814 TIMBER WAY
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��fie,an O>,�. <br /> a Pv. <br /> i �\ C m <br /> o SDVOSB <br /> a <br /> CVE <br /> Veterans National Property Services <br /> CCC1332569 <br /> CCC033729 <br /> 13215-G N Nebraska Ave. <br /> Tampa, FL 33612 <br /> (813) 609-5596 <br /> City of Zephyrhills <br /> Building Department <br /> 5335 8t'St. - . <br /> Zephyrhills,FL 33542 <br /> To Whom It May Concern: <br /> I,Paul Malek,designate the individuals listed below as Authorized Agents of Veterans National Property Services to act on my <br /> behalf,or on behalf of the prior named company/corporation in processing permit applications and conducting activities related <br /> to obtaining permits from City of Zephyrhills.The activities include signing all documents required of the Qualifier or <br /> Contractor. <br /> The signature of the Authorized Agent is binding and causes me to assume all responsibilities and penalties connected to and - <br /> associated with the Agent's signature as it may relate to my business.In addition,I authorize the Authorized Agents to bind me, <br /> and/or the corporation,to perform any requirement necessary to obtain•the permit. <br /> I,the undersigned,agree to hold City of Zephyrhills and all employees of City of Zephyrhills harmless from any and all damages, <br /> claims or other actions that may occur by reason of the Building Department/Permits acceptance of the Authorized Agents <br /> signature for permit application activities.I further understand that is my sole responsibility to designate and terminate authority <br /> and to ensure that the Building Department/Permits receives timely written notices of any changes in the Agent's status. <br /> I,the undersigned,being the contractor as either an individual or qualifier of:a corporation,do hereby <br /> affirm that all information in this letter is true and correct. <br /> `I- <br /> P ul Malek,Qualifier Contractor <br /> Pk—CCC033729 <br /> 13215-G N Nebraska Ave. <br /> Tampa,FL 33612 <br /> Authorized Agent Printed Name: <br /> 1) Angela Fischer 3) Amanda Calles 5) Brennan Choate <br /> 2) Edwin Ortiz 4) Donald Carey 6) Scott Worthley <br /> Sworn to anj subscribed before me this_L day of 202o,by �Z/3 /�..k/� as <br /> (,2,,a/,' 'c✓ of Veterans Nationdl Troperty Services,LLC,on behalf of said company,who is <br /> personally known to me or has produced as ide 'fication. <br /> My Commission Expires: <br /> Notary Public,signature <br /> RUBM CALLES <br /> Y'% MY COYJ&W ►d#GG 287205 Notary Public,printed name <br /> ' EXPIRES:Apn11?,2023 <br /> o: <br /> Bor"ThruNolatYpublfcUndervrtkers <br />
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