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.. ; Fen e O�tlet of Tampa Inc. <br /> _ 2� 1 S. Falkenburg Road <br /> ampa, FL 33619 <br /> O fice (813) 651-3623 <br /> ax (813) 651-3655 <br /> AUTH RIZED AGENT FORM <br /> I, Jeffrey Tinnon, of Fence Outlet of Tam I c having personally appeared for identification, do hereby <br /> authorize the following to act as my Agent(s in submitting Permit Applications in the area of City of <br /> Zephyrhills. <br /> (1 l <br /> Ana King K520- 12-87-710-0 <br /> —� <br /> �2� _��� <br /> Garret King K520- 90-82-334-0 <br /> (3) � T <br /> Daniel Paniagua P520- 74-91-258-0 <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 Januarv 23, 2015 C10252 <br /> C nt acto Sig ure Date Registration/Certification/License Number <br /> NOTICE: THE LICENSED CONTRAC OR'S SIGNATURE IS TO BE NOTARIZED <br /> State of Florida <br /> County of Hillsborough <br /> The foregoing instrument was acknowledged befor me this 23 day of January ,2015 <br /> By Jeffrev Tinnon ,as Vice President of F ce Outlet of Tam a Inc. and is personally know to me. <br /> JU l�+'�-- �v,•�., PENNY FERNANDQ <br /> N tary's Signa ure �::4� ��� MY COMMISSION#FF060060 <br /> �,��y:;; EXPIRES:October 3 2017 <br /> %�OF fl�P�` Bonded Thru hbtary Pu61ic Undetwriters <br /> Commission Expires: October 3,2017 <br />