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<br />~WAYNE <br /> <br />Automatic Fire Sprinklers, Inc. <br /> <br />Company's Name Wa..)'ne.. .4t..{Jo~.!I.::l:jL F(ve.. Spl"J'I-Jk.l-fr.tJ:he.. <br />Qualifie.r Name f'..e+ e.. S c It ~~~.__.._.____.__ <br />License Number '10"1...9 Jl.fO({)Q.~"=-1J2f;?~~_ <br /> <br />I hereby authorize the . C "+'!..s2..f--.2.t;eh.)!rjdM _.. to issue permits <br />to -~':LiI."Vlde.Y) _____""_' whose position with my company is <br />.-1Le."r.i9!:L __._________ <br /> <br />Check one: <br /> <br />) This authorization is good for the job al: ____ <br /> <br />( X) .Any and all pemlits until further notice. __.______.__ <br /> <br />lhe permit must be signed in front Mthe bud ' <br />understand thai I remain fully responsible for al <br /> <br /> <br />--3dJ-Og__ <br />Dale <br /> <br />a.. .This action must bear the notarized signatllre of the license holder. H <br /> <br />STA TE OF FLORIDA <br />COUNTY OF Of.. A ~6 t_ ___ <br /> <br />"~~~\!;<t", <br />(. t~'~':'a <br />~;..I.~'Q'" <br />~i.....t~~,.. <br />,,_.""~f,,~1I <br /> <br />"l'sC- <br />The forc.g oing instrument was ac~.p(lwledged before me this ~ _ day of <br />--~_200~by.~ ~hl..~~b__ <br />~ e of person acknowledging) <br /> <br />~Cc... QC1~ <br /> <br />-':otary Signature <br /> <br />RUTH A. MCCULLOCH <br />MY COMMISSION # DD 485833 <br />EXPIRES: February 26, 2010 <br />BOrldtt1 ThtU Notary Public Undelwn:'3rs <br /> <br /> <br />Per50 na l/y IProfess ionally Kn O'-Vll_.lQ...._..___.._ <br />-or- Produced Identification <br />-.--.....--.....------...- <br />Type of 10 Produced <br /> <br />-----.---....-..--.--...--. <br /> <br />Post Office Box 770. Brandon, Florida J3509-0770 . (813) 267-0076 . FAX; (813) 654-J419 <br />"------~;ror;He Office: 222 Capitol Coun . Ococe. Flonda 34761-3033 . (407) 656-3030' FAX (407) 656-8026 <br />i,' " (' ii' IIlI i () Ij'iCr' .\" J oeks!! 11 ,. i II e Fo /'( ,l I ,,' r y F' 01/11'(/110 B eo eli Concort!. :V C <br />