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uu uo: Clp ti H Constrution 8137156585 <br /> p.1 <br /> • <br /> StJB- CONTRACTOR AFFIDAVIT <br /> DATE: 4 713 - O } <br /> TO WHOM IT MAY CONCERN: <br /> • L cOL(,)a,rcL P. L ege i <br /> dlbia I-11 •_ • a �� <br /> i <br /> Iaccnsc Nitateri (c C 13 QO 1 C 4 . 3 1 , will be t t t c t°1 P_cfiri C Q,/ <br /> (Example; Electrical, Nfechszical, <br /> contractor for this permit application. The job addraas <br /> Plumbing, Roofing, Get, Etc.) <br /> is: 3 . 13 (e , u (otY\ Av r <br /> p 0j2 <br /> • <br /> Signature of Lij Holder or Ambsktted Agent <br /> STATE OF FL.461,■A <br /> COUNTY OF 1'46. <br /> • <br /> 1 HEREBY CER.TIFYitat the .oregoing iasxumcut was swum to and subscribed beforeine this <br /> day of • . by £ rt _ <br /> • `o L. A 1� • who hac ., <br /> idea: I . We\ <br /> Signature of Notary Public . Notary Public State of Honda <br /> Sabrina Rae Cant <br /> r A l My Commission DD463268 <br /> Print, e oa a Expires 08/1812009 <br /> S ane or Notary <br />