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12-12909
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2012
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12-12909
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Last modified
2/12/2013 11:43:44 AM
Creation date
2/12/2013 11:43:41 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
12-12909
Building Department - Name
MCDORMAN,ROBERT
Address
5929 18TH ST
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. � <br /> Fire&WatQr- Clea,up& Restoration'"' <br /> V <br /> CONT'RACTOR AUTHORIZED FORM <br /> STATE CERTIFIED LI� # CGC014994 <br /> PASCO CONTRACTOR ID# 004351 <br /> QUALIFERS NAME - �,AIRD, RANDALL W. <br /> BUSINESS NAME— SLRVPRO OF TARPON/WEST TAMPA <br /> ' I authorize the following individual(s) to sign for and obtain permits, record <br /> my state contractor license(s) and create passwords o:� my behalf regarding <br /> the above mentioned license. <br /> DONNA LOTZ of PERl`vIITS PLUS <br /> PAUL TUGGLE of SERVPRO of TARPON/WEST TAMPA <br /> �`*This authorization supersedes al� previous submitted authorizations** <br /> �---�, <br /> / f <br /> Signature of qualifier: ;'� � <br /> Sworn to and subscribed before this day <br /> :��. T w'�:�. :;-t.��.t�GttA <br /> =': :� PNY C�MMIS:�IGN#DD988734 Ttl r /� <br /> �. '.� �X�iR�S;�1ay 31.2014 � �A`� D C �� ��4 <br /> �0 398-0153 f ' pp� J� <br /> /` f� <br /> Nota Public <br /> State of Florida <br /> In�lepe�t�lejttll' ()tt�nrd�rn�l O�er�rte<l <br />
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