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10-10340
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10-10340
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Last modified
1/28/2011 11:19:29 AM
Creation date
1/28/2011 11:19:27 AM
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
10-10340
Building Department - Name
HOLLIDAY FAMILY ENTERPRISES INC
Address
5407 5TH ST
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LETTER OF AUTHORIZATION <br /> I hereby authorize B df VV, <br /> Of R e mtu cec■ng < n c- <br /> to sign his /her name on my behalf in order to apply for a rop , r � <br /> permit for work to be performed at: <br /> Lot /- ( Subdivision <br /> Address 61'07 5/k tk St . zeffterikks 1 rL 33672_ <br /> ■ o04 ;ng �Ac . CCC - os2a <br /> Type or print name of company License number <br /> \A i 1--koroicl 1�1. Steed , ,fir. <br /> Signature of licensed contractor Print name <br /> The foregoing instrument was acknowledged before me this \ day of <br /> Qyr-11 206.16. <br /> By \-\ c>.c Ak W 3\ e.RA Jr (name of person acknowledging) <br /> N <br /> State: loc- ∎ c", t► 1"'� ._„_,4_______„ <br /> County: G c .),5 Signature of Notary <br /> Personally Known or Produced Identification N <br /> ID# �1 <br /> 4 SHARON DUROCHER i <br /> 4 itif Nohry Public - $ fW M Florida <br /> 1 . t Con <br /> ! My Con an . Expk Sp 6, 2012 ` <br /> aaosion • DD 916519 <br /> loaded firs. NNW Wry Aaa. 0 <br /> Notary Stamp <br />
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