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t <br /> A & M Electric <br /> ll47 E Heartwood Drive State Certified <br /> DeLand,FL 32720 EC0002815 <br /> (386) 734-2864 Fax: (386) 736-7096 <br /> PERMIT AUTHORIZATION <br /> I, John W. Matthews, Jr., hereby authorize �����j'��,�,��.i� _ sign <br /> for and to obtain an Electrical permit and/or any required licenses in <br /> my behalf under my License # EC0002815 for the job described below: <br /> DESCRIPTION: <br /> Owner: Shiva 6005 Gall LLC <br /> 8100 SW 178`h Street <br /> Palmetto Bay, FL 33157 <br /> Site Address: 6009 Gall Blvd <br /> Zephyrhills, FL 33542 <br /> Parcel ID #: 03-26-21-0010-11200-0041 <br /> � � ��- <br /> (License Holder Signatur ) ( ate) <br /> State of Florida County of Volusia <br /> Affirmed and subscribed before me this� day of��, 201� <br /> By John W. Mattnews, Jr., who is personally known to me. <br /> � � aJc�I��� <br /> Notary Public Sign ture) (Date) <br /> RY A� ppSALINE L.OGLE <br /> otary Public SEAL �°s: a�% <br /> State of Florida * � � * NIYCOMMISSION#EE08484; <br /> s Q EXPIRES.April4,20]5 <br /> �'TF�.«o�`O 6�nded Thru Bu�.9t Notary Sernce� <br />