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<br />~I <br />WAYNE <br /> <br />Automatic Fire Sprinklers, Inc, <br /> <br />Company's Name W'~<:-_l!.y~_.~~qf-t.:.<.. E.i!"e... S'p,.,.,...? k..1-fY' JiII4 C. <br />Qualifies:Name fe+-? SC"'kE_~.____._.______ <br />License Number...3 0 '1-. Cf.$ <:ta>OQ.~1.. <e. 0 '1- <br /> <br />I hereby authorize the -=-~._~ f' -k~l1_y r J., "., 1$-. . to issue permits <br />to ..i.!oe..Tct '110'-' ---_..__.._____.._..__.__, whose position with my company is <br />h.p S' 'oJ. <br />----1L.",__L_.:L .':1-______.____._________. <br /> <br />Check one: <br /> <br />) This authorization is good for the job at:________ <br /> <br />ex:) Any and all permits until furrher notice._____________ <br /> <br />____-3.. d) -()p <br /> <br />Dare <br /> <br /> <br />presentative. I <br />ed ) der said permits. <br /> <br />,. hThis action must bear the notarized signature of the license holder"" <br /> <br />STATE OF FLOR1DA <br />COUNTY OF {')PJi i\J6 [' _ <br /> <br />"} -iT <br />TIle t()H~going instrumenl was acknowledged before me this e.L day of <br />----L"Cn..LC \..... 200E, by_-J~Q. ~~..J:L. ___ <br />(n~rne of 2!rson acknowledging) <br />~';I'.,'r,il"h~~~~ <br />'sr \...."'~'~:?" RUTH A. MCCULLOCH ry , 1(( ~ .flVI ^ /" (1 (\ -" I <br />(....f A~~""':~~ MY COMMISSION ff Dp48583,) '~~-L~{ ~d ~ <br />~:: .. .&E EXPIRES: Februai'j tb, 201,0 . Olary SlgJ13ture <br />-;'..~;;;.. ..'b~"':- I?ondwd Ttltl.l Notury PubliC UnderNlt,r,Jrs <br />"'Rf,,\~' ._ <br />=~ ,,~.... <br /> <br />Personal I y IProfess i0naIJ y Known_~____.....___. <br />-or- Produced Identification__ <br />Type of IO Produce.d _==.~._==_==~ <br /> <br />Post Office Box 770 . Brandon. Florida .B509-()77() . (SU) 267-0U76 . FAX: (813) 654-3419 <br />- <br />-----.-..(~:)rpOr'lle Office: 22::: CJpito] Courl. Oeoee. Florida 34761-3033' (407) 656-3030' FAX (407) 656-8026 <br />;;'1"'[('''(1/ O/ficc'.': .!ocksolll.jlle Fori ,\-f.\'C!" POll/POliO Beach COlicord. NC <br />