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ALL-STATE PLUMBING 540 E Minnehaha Ave. <br /> - Clermont,FL 34711 <br /> Services,Inc. Tel:352-874-4225 <br /> E-mail allsiplumbinunvahoo.com <br /> CFC 057323 <br /> CONTRACTOR AUTHORIZATION FORM <br /> STATE LICENSE NO.. <br /> CFC057323 <br /> PRINT QUALIFIER'S NAME: JOEL CASIMIRO <br /> BUSINESS NAME: ALL STATE PLUMBING SERVICES <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 /> Dou-qc'-C-4- 131r cc C e C. t/ <br /> : f <br /> Signature of Qualifier: = Date: <br /> State of Florida. <br /> S AP sc rthis day f`�� JtM✓+�ztr 2-G1-� �, ,��.z I ��,3,'nn+ice <br /> . RebM=Eephens <br /> MY Cammi 3km GG 95W8 <br /> �i,r Expimso211&W24 NdtgFy Public State of Florida <br /> (Stamp) <br /> My commission expires 2 'C Z` <br /> g/devsvcsdocuments\l-documentspecialists\bcs\bcsforms\ContractorAuthorization Form Revised 4/3/17 <br />