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<br />Dlue Dolphin riberglass Installations <br />4001 West M.L. King nIvd. <br />Tampa. F'lorida 33614 <br />(813) 872-7671 <br /> <br />APPLICATION ron PEI~MIT <br /> <br />JOh,u (JIOCClO <br />~ner's Name L ~ <br />~8"9aff C-Rve. <br />.AdQr~~s <br />~Y~h,'f)s) Fe., '33540 <br />City Slate Zip Code <br /> <br />CONTRACTOR: <br /> <br />Blue Dolphin Fiberglass InstaHations, Inc. <br />CPCA 110 18 <br /> <br />Installation of a fiberglass swimming pool al lhe above address. <br />CONTRACT DA'J'E~ ~ ,5"J;fJ7eWl!J ~ /9 Cfcr IJO ' 64/6 <br /> <br />J. lJOh tJ Q R-acc 0 (homeowner), of J?9'cf(? sn /Jb.e. <br />ZeJJhyllh I'Jl~ II. JJ>64-0 (address), hereby give <br />permission lo mue Dophin F'iberglass Inslallations, Inc. lo sign in my behalf <br />for lhe application permit for a swimming po'ol and. if needed. screen <br />enclosure or any olher pool inslallation additions on my behalf for contracl <br />entered into referenced above. <br /> <br /> <br />Sworn to and subscribed before me <br />this 7 day of Se,qe~-et2. <br /> <br />l~ -;d&I <br />/)JIJ~ <br />Nolary Publ c <br /> <br /> <br />