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11-12421
Zephyrhills
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Building Department
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2011
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11-12421
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Last modified
6/12/2012 11:33:14 AM
Creation date
6/12/2012 11:33:12 AM
Metadata
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Building Department
Company Name
CITY OF ZEPHYRHILLS
Building Department - Doc Type
Permit
Permit #
11-12421
Building Department - Name
CITY OF ZEPHYRHILLS
Address
5002 AIRPORT RD
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19/05/2011 12:25 1525673177 PAGE 02 <br /> . � <br /> 07-�'i��017 <br /> .� Arn�►1'� STATE OF FLORIOA <br /> c►� �wcw. o�e O�PARTMENT OF �INAMCIAI. S'ERViC�S <br /> DIVISION OP WiQR1�RS' COMPENSA7'ION <br /> �* CERTIFICA'I'� QF EL�TION TO �6 �XEM� FR�IYI FtOMDA M/0111(ERS' I�ENSAT'IQN U1W *+� <br /> CONSTAI/�"TION II�DUSTRY EXENAP'7'ION <br /> This certifies tluit ths indiv�dw! lialed hslow h�a efected to be exen�pt fron+ Fiarid� Wakers' GomPe��tio� law. <br /> H'FECTiVE DAIE: 09/2�/�011 EXPIRATION DA7E: Q9/241�013 <br /> PER�301�k MAC:E J/►MES R <br /> �EIl+� �3�723� <br /> 9tlSMIESS NAME AMD /►pDpESS: <br /> JAV 2 INC <br /> O�A Oq1l�LE M !LlCTRIC <br /> 10410 RIYER RD <br /> D�ADE CIl'� f� 8901d <br /> SCOP�S OF BUSIPESS OR TliA[�E: <br /> 1- REOYt'1�E0 ELECTRICAL OOI�RIWCT <br /> MM'OMTANr: *ro� a CM�w a�o . Oft111. F„f.. N dtk.r �1 ���w�11w nM N� �n+11w �w W� e�Mw M� f11N� r oMll�cr+ d N� �Nr Mk <br /> �Iw� .�y +�! new�r M�Ntu a cw�wlMM wN� IMt eYylw. hrw�M N py1K M�.�i1tTl, F.!-. CrlNlab� M N�e1tM M M�w�l... �INI► �M1r w�Y Ilr <br /> !ll�e N w MnMN� M M�N IINM M M�MIe1 d d«IN� N M�rr�M. hfwNll N CMMM �N.OtAI�, i.f.. NMlpa � M�WM b Y� 1w�1 � c�e1MkY� �f <br /> d�plM N N�11�t �N M Y�JW Y faqCMIM %�1 �ry tlM � M HIN/ N M IMIp �r � f�Yt� N IM s«Nlk�. M�ww ��MI M MM rMw �t <br /> eM1MInN r I�NM M�d 1M f1M�tMM1� d Mb MRltw IN NuMM�e� �� drlNicMS. 1M M�r1�N1 �MII 1w�M� r wIM1aY �� tNM (N 1MYr� d IM N�w� <br /> ,.r.+ .. M. s.nMkM. u w..� w n�wr...w .► IMb s.a1M. QIIESTIONO'r i�6� 4t3-1609 <br /> OYVC-46Y CERTIFICATE OF EtEGTION TO 8E EifBYPT NEYISEO Ot-11 <br /> PL�A$E CUT OUT THE CARO YELOw AND R�TAIN FOR FUTURE REFERENCE <br /> i�A1L O� w.alqll M�ORTANT <br /> a►n��of 111�1�COM�a�'nON F Purswnt m GA�/4r 4�LL05tt41. F.S.. �n �fliar ef a a►*or� whs <br /> Cd�iTM1CT=O1 IIOtI�TRY � sa�n f►am this c�rPw M► fNin� � cs►Nfi19�b �f eketien <br /> cetiM�CItTE OF B.�c'1fON To ee at6NPt i�ltoM Ro�e1cN and�r tNs section mp not rsarar �enefia a oM�a� a�der tl�is <br /> 11YOIM��' �OII��ISI1110N LJqIU � �� <br /> EFFECI'INE �/��1�011 EXPlRATION DA7E t 0�/Z4/ a Pur�ant b Ch�1�r 44Q0511?l. F.S.. GrlifiuNs of �NCIiM� to N <br /> PERSOnk J1111ES R MACE N exenMt... �N1� NN�► within ws sd�s of the halne�s sr a�N Nsted an <br /> FEI�R ��2� R qN netia ef eketiM� te N �xa�t. <br /> BI�SS N11� MD ADDRESSc E Pu�t N Ch�p1�r 44a05{1Z1. F.S. Nnlcas ef abeCi�n al k ex�mpt <br /> r,v x wc �nd wrtif icaes ef eNMien 1� M•x.■yt �II M a�iw� �• r�aeatlon <br /> ��E M� il, a! in�1 ti�11e af1e� 1�I1e tNY1� �f NI! M'lICO �r Me iil111nee ef IM <br /> +w+o m� w cartifi�es. tM PRS�n �rN �n 1he �e�ie� �r prtifieals ne len/er nNets <br /> w�o�e cm, Ft aasxs the ►e�irae�a of Nfs saties hr i�a�.�ee ef a wrefia.er. 'tbe <br /> reNrA�nt diW rewke • crrNftat� at �ry tin�e fa hiNre ef �ha <br /> SCOP� QF 6lJSM�ESS OR TAAD� I�son nK+�ed on �he eatifiwle to meet �e re�'wnnenes �f tli� <br /> +- �e�o aecr��l corrp�er l�cdan. <br /> nu�snoNar usa +,a-,so9 <br /> �� <br /> • Carry boaom portion on th� l�• k�P �+PP� portio� far your r�aords. <br /> OYVC-25T CEIIT�ICA7'E OF ELECTION TO 8E EXEIIN'T REVISEQ 01-t1 <br />
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