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Fen e Outlet of Tampa Inc. <br /> �� = 2 1 S. Falkenburg Road <br /> Tampia, FL 33619 <br /> ffice (813) 651-3623 <br /> ax (8� 3) 651-3655 <br /> � I <br /> AUT ORIZED AGENT FORM <br /> � <br />� I, Jeffrey Tinnon, of Fence Outlet of Tam a Inc., having personally appeared for identification, do <br /> hereby authorize the following to act as my gent(s) in submitting Permit Applications in the area of <br /> City Zeplxy,rhills. <br /> ti <br /> � 7 <br /> , <br /> � a Ki g K520- 12-87-710-0 <br /> I UNDERSTAND THAT I AM THE LICENSED Q ALIFIER RESPONSIBLE FOR THE APPLICATION AS <br /> SUBMITTED BY MY AGENT(S),AS REFEREN ED ABOVE. I FURTHER ACKNOWLEDGE THAT THIS <br /> ORIGINAL AUTHORIZATION FORM IS IN MY ICENSE OR QUALIFICATION FILE FOR LEGAL REFERENCE <br /> PURPOSES. <br /> x ��i��o'+�— x October 27, 2014 C10252 <br /> Contr r's ignature Date Registration/Certification/License Number <br /> ,� <br /> NOTICE: THE LICENSED CONTRAC OR'S SIGNATURE IS TO BE NOTARIZED <br />� <br />� State of Florida <br /> County of Hillsborough <br /> The foregoing instrument was acknowledged befor me this �"� day of ��� ,2014 <br /> By Jeffrev Tinnon ,as Vice President of Fe ce Outlet of Tam a Inc.and is personally know to me. <br /> i <br /> tary's Sign ure � <br /> Commission Expires:October 3,2017 I <br /> •,;i�"�'"y�•,.t PENNY FERNANDQ <br /> `*' �,� MY COMMISSION#FF Ofi�06p <br /> y EXPIRES;October 3,2017 ' <br /> • ,J�"' ��'�,� Banded TMv�blory Pubiic Undenvrite�s � <br /> �u�� <br /> I <br /> i <br /> I <br />