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10-10421
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10-10421
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Last modified
2/1/2011 8:41:01 AM
Creation date
2/1/2011 8:40:58 AM
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
10-10421
Building Department - Name
BIRMINGHAM,MATTHEW
Address
5336 16TH ST
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H SUPERIOR <br /> t:NCE RAIL ric, <br /> Where Qualit% l'ilatters! <br /> 1400 Starkey Rd <br /> Largo Fl 33771 <br /> (Tel) 727 -536 -1905 <br /> (Fax )727 -585 -8500 <br /> Date: L4 , ` 01 1 <br /> RE: LETTER OF AUTHORIZATION <br /> I, Christopher Johnson, holder of a PCCLB number C- 10418, do hereby authorize the following to act as <br /> my agent(s) in submitting permit applications and obtaining permits as well as make changes to permits <br /> and plans, initial changes made by the building dept and/or sign applications for the qualifier: <br /> Authorized Agents: <br /> 11 1 uaW bnd fx 1 CroSb el i p liurmal <br /> 1 unders . • at I, as the li sed qualifier, am responsible for any application submitted by my agent(s). <br /> G <br /> C topher Ja2rn <br /> Contractor SiF' ure <br /> State of Flori4a, Coun of 0-e 1 `Q sworn to (or affirmed) and subscribed before <br /> me this 3pfi ay of 1 , 2040 <br /> Notary Seal: Notary: <br /> Signatu of Notary Public -State of Florida <br /> : STEPHANIE R MARTENS <br /> MY COMMISSION # DD830126 `< <br /> r r `3 <br /> EXPIRES October 09, 2012 <br /> Print Commissioned Name of Notary Public <br /> (407) 398 -0153 FloridallotaryService.com <br /> Personally KnownWOR Produced ID [ ] <br /> Type of Identification Produced <br />
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