Laserfiche WebLink
<br />~] <br />WAYNE <br /> <br />Automatic: Fire Sprinklers, Inc. <br /> <br />Company's Name WQj;~~.:l:E.;..,'!'!:~!~~ F/rc.. SPYI'1 k f-et"'.S; +"> c., <br />Qualifier Name ---.fr...:i:e.. 5c b..~::1_~_..._._~___.,. <br />License Number _ q 0"- '13400 O.'2.1-..f.:?Q~_ <br /> <br />I hereby authorize the ~,~..12P2f.~r--.!l11l.J . , to issue permits <br />to -J'...e.fl!:L Wq+SOJL..________._.______, whose position with my company is <br />0(" <'1'iPJ i'1 . <br />"---.~--~._~~-------_._--_.__.~~---._.---- <br /> <br />Check one: <br /> <br />) This authorization is good for the job at: <br />-,.----._.~~ <br /> <br />( )Q r\ny and all pemits until further notice..______ <br /> <br />---~J-D~ <br />Dale <br /> <br /> <br />*.....This action mllst bear the notarized signature of the license holder". <br /> <br />STATE OF FLORlDA <br />COtJNTY OF 6R f:)f\.}(; ~ <br /> <br />."...._-<o...>t'.\.~"i_':''I''.;:,;'\"....;,;...._\...".<;'''_.;,,,........!...~ <br />(~ S4:pr---"" ~'-Rl[iH'A,MCCUU:(};H <br />;:':;r :" COMMISSION # DO 485833 <br />., ,1,,;) . LXPIRES: February 26,2010 <br />):.., :"'1100 11'1", NOlllty Public Underwriters <br />:._,~~"....,,-..._~ <br /> <br />PersonalI y /Professionally K.n OWTI_.__'i!._____ <br />-OJ'- Produced ldentification <br />Type ofID Produced -===-=--=--=- <br /> <br />1'\ J S-t: <br />The foregoing instrument was acknowledged before me this oL day of <br />---tf:a.L~_ 200&>, bY--M€- S~~b <br />(name o~person aCknowledging) <br /> <br />-- ._, !1} t. OCloc:t---. <br /> <br />. otary Signature <br /> <br /> <br />Post Office Box 770 . Brandon, Florida 33509-0770. (813) 267.0076. FAX: (813) 654-3419 <br />Curpori\[e Office: 222 Capitol Court. Oco('c. Florida 34761-3033 . (407) 656-3030 . FAX (407) 656-8026 <br />!""c/IlJ!/lf 01[11'(',1: J()('/';solll'ille r'll/'! '\{ycn PO'1/pallo Beach COllcol'd, NC <br />