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HomeMy WebLinkAboutRS160070_Agent Notarized LetterLETTER OF AUTHORIZATION Santa�wCA92703 ® 714.667.8888 .......... ...... _..... ---- ...... -... ...._....... ... ........ .._............. _............... -.......... ...... - ........ ...... ®ocpCustomerCare@ocpw.ocgov.com I envw.ocplanning.net ; ® 714.667.7575 In order to protect your interests, it is the policy of this agency to limit the issuance of permits to those parties responsible for said property and to limit communication from staff (including, but not limited to: engineering plan checkers, engineering -geologist plan checkers, planners and zoning plan checkers, and management) to only those parties designated by the owner/financially responsible party as authorized representatives with whom they would like staff to directly communicate. All permit requests are to be executed by the permittee or an authorized representative of the permittee. Delegation of signature authorization in no way absolves the permittee of the ultimate responsibilities pursuant to the permit. The person(s) indicated below are authorized to: M Execute (sign); ❑ Communicate with Staff regarding the application(s); ❑ request, and/or W Take all necessary action on my behalf, pertinent to obtaining permits. Permits in the name of (Name of Company) and/or (Property Owner) 3 Pz I o c OL^ % 0/-, /- a / 5/ 7"i-a. C*?' t aj 3 Al,.,' Location of work: C a a g r- C A . 12-.S 6"'7 In our/my behalf the following person(s) are authorized to act, as indicated above: !q r C ` a—., W Wi! e © ;;t- l�ae 6Z cs .e (Printed Name of Authorized Person) (Title and/or Name of ompany) , PERSON GIVING AUTHORIZATION: "ro R F. m _ (Printed Name) (Signed Name) Title: r/-0, t.t-f - C) {Compa Officer and or (Property Owner) Authorization Expires: ✓:r/,, P2cs /? (Date Note: You must have your Letter of Authorization notarized using the Certificate of Acknowledgement attached. The Certificate of Acknowledgement must be completed by a Notary Public. (Law enforcement and local and state governmental agencies are exempt from the notary requirement.) .TE OF ACKNOWLEDGMENT A notar/ public or other officer competing this certificate verifies only the identity of the individual who signed the document to which this 3ertificate is attached, and not the truthfulness, accuracy, or validity of that document. State of Countyof Los eS l p t1 On J u, \,IakU before me, Ply Pl �. `a � �io� personally appeared t (Insert name and title of the officer) -TpCQCZa— L—)�-k , who proved to me on the basis of satisfactory evidence to be the person(s)— whose name(s} is/are-subscribed to the within instrument and acknowledged to me that h sTi Ilhey executed the same in hi6ei /their authorized capacitydjrs), and that by his/40kheir signature(s) on the instrument the perso , or the entity upon behalf of which the person(s) rated, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. (SEAL) ..;;. R1TA M. PATEL ,,' COA�M. #2006237 m i V Notary Public - California 1 SIGNATURE OF NOTARY PUBLIC m p LOS ANGELES COUNTY AM Comm. Exp. Mar. 2, 2017