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HomeMy WebLinkAbout120 Laurel Ave 17-185; ROOFw C E IVE f JAN 17 20V CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION F- D Application No: j Documented Construction Value: $ XJ Job Address: iao LQu(d Ave -nut, Historic District: Yes N No Parcel ID: _5"/ 9' e30 -5R6 6309" cow Residential Commercial X Type of Work: New Additioon Alteration Repair 91 Demo Change of Use Move Description of Work: 'Rum --T?C) Plan,ttv-iew Contact Person: e: Mo'7-'R7 q o9939 L©r- " Name R. zoo Title: Email: al IC had ZC.1 022 - iL C-oM Property Owner Information Street: 3 1 to e3xil igm sfaf_i City, State Zip: Dri411 a0, rL20,1R11Phone: Yy%'7%0 -Dy l Resident of property? : IJo Contractor Information Name 2 Phone: Street: d?oX wi l yy 5 Fax: /J J City, State Zip: LjML Mona, FL- 39941? State License No.: Ctl &5r%H5 Architect/ Engineer Information qy? Name: i 1;} Phone: Street: City, St, Zip: Bonding Company Address: Fax: E- mail: IJ la Mortgage Lender: 144 Address: WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. 1 understand that a separate permit must be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, and air conditioners, etc. FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 51h Edition (2014) Florida Building Code f ppRevised: June 30, 2015 Permit Application v NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713. The City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy of the executed contract is required in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal. The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value, credit will be applied to your permit fees when the permit is issued. OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Print of Date ERINlMr MY COMMISSION 1 FF 130468 EXPIRES: August 28, 2018 i+;W Bonded Thru Notary Public Unden iten! 11 Owner/Agent is -' Personally Known to Me or Produced ID Type of ID 1 177 Signature of Contractor/Agent Date Print t ctor/Age 's Name Sign ire of Notary -State of Florida Date r np, LORI A PERINA MY COMMISSION 9 FF 130468 A*-. A'-,'.0 EXPIRES: August 28, 2018 Bonded Th. Notary Pubr Undrwrdera Contractor/ Agent is Personally Known to Me or Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY Permits Required: Building Electrical Mechanical Plumbing Gas Roof Construction Type: Total Sq Ft of Bldg: Occupancy Use: Min. Occupancy Load: New Construction: Electric - # of Amps Fire Sprinkler Permit: Yes No # of Heads APPROVALOcc ONING: UTILITIES: ENGINEERING: FIRE: Flood Zone: of Stories: Plumbing - # of Fixtures COMMENT' P—a"' Fire Alarm Permit: Yes No WASTE WATER: BUILDING: Revised: June 30, 2015 Permit Application WZ EE' S CONTRACT Roofing and Construction Inc. CCC1325745 & #CBC058448 To: Douglas Bolt Bolt Ventures Inc. From: Michael Zent Date: January 19, 2017 Re: 120 Laurel Avenue Sanford, Florida 32771 ZEE'S CONSTRUCTION INC. agrees to furnish all permits, labor, materials, insurance, and supervision to perform the following. Scope of Work: Re -roof — 5 Squares Specifications: 1. Remove existing roof system down to the roof deck. 2. Install 12' wide sheets to plywood decking and tectum with Carlisle 100 fast foam adhesive. 3. Install Carlisle white TPO 115 fleece back, heat welded roofing system. 4. Install new white galvanized aluminum drip edge. 5. Install new vent boots if needed. 6. Clean up and haul off all construction debris. Application Fee: $25.00 Base Permit Fee: $40.00 Total Labor & Material: $65.00 Note: All labor and materials to be donated. PO Box 471445 Lake Monroe, Florida 32747 407-878-2225 SEA?INOLE COUNTY MULTI%UR/SDICT/ONAL LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: I 11ag 1 t, D I hereby name and appoint: ke- .Vt4. P L cnt" q an agent of: 26C 15 eofis r" ffiyn Name of Company) to be my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all things necessary to this appointment for ( check only one option): R All permits and applications submitted by this contractor. Or The specific permit and application for work located at: Street Address) Expiration Date for This Limited Power of Attorney: 1-i - a g' License Holder Name: I (aciu - zsnt State License Number: lA.) C qyb / Signature of License Holder: STATE OF FLORIDA , COUNTY OF t7 S 41l ,-"p The foregoing instrumentwasacknowledged before me this day of /t)Oltr, 20_, by zdIcc ] Z C 11 who is personally known to me or who has produced as identification and who did ( did not) take an oath. Signature of Notary BRIAN DEARING Notary Public -•State of Florida commission #r GG 001224. 3+1 I` lylld@ ' % 3 1y comet. Etcplrea Jun 13, 2020 ti»'•`,, Bonded throughNational Notary Assn. Print or type Notary name Notary Public - State of FL Commission No. 4- 0012 2 My Commission Expires: ( a // ( INTERNAL REVENUE SERVICE P. O. BOX 2508 CINCINNATI,, OH 45201 Date : J U L 2 2 2015 ADL SERVICE DOGS INC 7928 PINE CROSSING CIR 416 ORLANDO, FL 32807-8285 Dear Applicant: DEPARTMENT OF T1 Employer Identification Number 46-4148531 DLN: 26053598001935 Contact Person: CUSTOMER SERVICE I1 Contact Telephone Number: 877) 829-5500 Accounting Period Ending: Janaury 31 Public Charity Status: 509(a)(2) Form 990/990-EZ/990-N Required: Yes Effective Date of Exemption: July 15, 2015 Contribution Deductibility:, Yes Addendum Applies: No We're pleased to tell you we determined you're:,'exempt from.federal.income tax under Internal Revenue Code (IRC) Section 501(c)(3). Don8-rs-6an d'educt- contributions they make to you under IRC Section 170. You're also qualified to receive tax deductible bequests, devises, transfers or gifts under Section 2055, 2106, or 2522. This letter could help resolve questions on your exempt status. Please keep it for your records. Organizations exempt under IRC Section 5.01(c)(3) are further classified as either public charities or private foundations. We determined you're a public charity under the IRC Section listed at the top of this letter. If we indicated at the top of this letter that you're required'to.f.ile Form 990/990-EZ/990-N, our records show you're required to file an annual information return (Form 990 or Form 990-EZ) or electronic. notice (Form 990-N, these -Postcard). If you don't file a required return or notice for three consecutive years, your exempt status will be automatically revoked., If we indicated at the top of this letter that an addendum applies, the enclosed addendum is an integral part of this letter. For important information about your responsibilities as a tax-exempt organization, go to www.irs.gov/charities. Enter 114221-PC° in the search bar to view Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities, which describes your recordkeeping, reporting, and disclosure requirements. Letter 5436 ADL SERVICE DOGS INC Sincerely, i Jeffrey I. Cooper Director, Exempt Organizations Rulings and Agreements Letter 5436 A, y SCPA Parcel View: 25-19-30-5AG-0308-0060 Page 1 of 2 Property Record Card O PParcel: 25-19-30-5AG-0308-0060Pj; A Owner: BOLT VENTURES INC SGwJOU: cowly,, a Property Address: 120 LAUREL AVE SANFORD, FL 32771 Parcel Information Parcel 25-19-30-5AG-0308-0060 Owner BOLT VENTURES INC Property Address 120 LAUREL AVE SANFORD, FL 32771 Mailing 316 GOODLAND ST ORLANDO, FL 32811 Subdivision Name SANFORD TOWN OF Tax District S3-SANFORD-WATERFRONT REDVDST DOR Use Code 11-STORES GENERAL -ONE STORY Exemptions p, 11 Legal Description LOTS 6 TO 8 BLK 3 TR 8 TOWN OF SANFORD PB 1 PG 61 Taxes Value Summary 2017 Working Values 2016 Certified Values Valuation Method Cost/Market Cost/Market Number of Buildings 1 1 Depreciated Bldg Value 22,053 22,385 Depreciated EXFT Value 4,879 4,879 Land Value (Market) — 71,370 71,370 Land Value Ag Just/ Market Value " 98,302 98,634 Portability Adj Save Our Homes Adj 0 0 Amendment 1 Adj 0 0 P& G Adj 0 — 0 Assessed Value 98,302 98,634 Tax Amount without SOH: $1,977.18 2016 Tax Bill Amount $1,977.18 Tax Estimator Save Our Homes Savings: $0.00 Does NOT INCLUDE Non Ad Valorem Assessments Taxing Authority Assessment Value Exempt Values Taxable Value Schools 98,302 0 98,302 City Sanford 98,302 0 98,302 SJWM( Saint Johns Water Management) 98.302 0 98,302 County Bonds 98,302 0 1 $98,302 98, 302 CountyGeneralFund98,302 0 Sales Description Date Book Page Amount Qualified Vac/Imp CERTIFICATE OF TITLE 10/1/2010 1 07457 0203 100 No Improved SPECIAL WARRANTY DEED 2/1/2008 06942 1106 275,000 No Improved WARRANTY DEED WARRANTY DEED 1 7/1/2002 8/ 1/1994 04450 02810 1615 0859 — 300. 000 No Improved 66, 000 Yes Improved WARRANTY DEED 3/1/1980 01272 1074 30.500 Yes Improved Find Comparable Sales Land Method Frontage Depth Units Units Price Land Value SQUARE FEET 14274 I $5.00 71,370 Building Information Year I# IDescriptions Actual/Effective Built I Stories I Total SFExt l/ Eff I Stories I Total SFExt I Adj Value ( Repl Value I Appendages Actual/ Effective 1 11977/1987 2 5281 1 $22.053 1 $33,163 http:// parceldetail.scpafl.org/ParcelDetaillnfo.aspx?PID=2519305AGO3080O60 1/17/2017 SCPA Parcel View: 25-19-30-5AG-0308-0060 Page 2 of 2 WOOD BEAM/COLUMN Permits STUCCO W/WOOD OR MTL STUDS Description Area OPEN PORCH 48.00 FINISHED OPEN PORCH 48.00 FINISHED Permit # Description Agency Amount CO Date Permit Date 00906 MECHANICAL - HEAT PUMP SYSTEM WITH DUCT WORK ISANFORD I $4,300 1 14/4/2016 Extra Features Description Year Built Units Value New Cost 4' CHAIN LINK FENCE 12/1/1977 72 115 288 COMMERCIAL ASPHALT DR 2 IN 12/1/1977 3,150 1,147 2,867 BLOCK WALL --- 12/1/1977 - _ — 2,484 2,981 7,452 CONCRETE WALKWAY 12/1/1977 566 566 1,415 6' CHAIN LINK FENCE 12/1/1977 29 70 174 http://parceldetail.scpafl.org/ParcelDetaillnfo.aspx?PID=25193O5AGO3080O6O 1 /17/2017 P 4 CERTIFICATE OF APPROPRIATENESS HISTORIC PRESERVATION BOARD CITY OF SANFORD 300 S. Park Avenue Sanford, Florida 32771 407.688.5145 • www.sanfordfl.gov/HP THIS DOCUMENT MUST BE POSTED AT ALL TIMES UNTIL PROJECT IS COMPLETED. ISSUED TO: Bolt Ventures, Inc. 120 Laurel Avenue Sanford, FL 32771 BP#17-186 DATE ISSUED: January 17, 2017 DATE EXPIRES: July 18, 2017 Approved reroof on existing flat roof that is not visible per the scope of work provided on application. Christine Dalton, AICP Historic Preservation Officer/Community Planner Please be advised it is the owner and/or agent's responsibility to notify staff of any potential changes from the approved COA that arise and obtain approval prior to commencing the changes. This Certificate of Appropriateness does not constitute final development approval. The applicant is responsible for obtaining all necessary permits and approvals from applicable departments before initiating development. IS A BUILDING PERMIT REQUIRED FOR THE ACTIVITY LISTED ABOVE? $ YES NO Qwll r Building Depart'dent Representative —J pa'I icU°s 4 APPLICATION # I'l — L 1?(0 FOR A CERTIFICATE OF APPROPRIATENESS Answer all the questions on this form and submit all required attachments. Incomplete applications will not be reviewed. If you have questions about application requirements contact the Historic Preservation Officer at 407.688.5145 to ensure your application is complete. General Information MV Downtown Commercial Historic District[]Residential Historic District[]Is this a retroactive request? Yes NoW Is this application filed in response to a Notice of Violation from the Code Enforcement Department? Yes[] No© Proposed improvements will affect the following elevations: North South East West Property Address: /o'RO LAUK'19LA\JgN Ub Property Owner Information Print Name: &LT V6tA-rLAr.CS %) . Mailing Address: O / S Phone: qP7-q7O-0011 Email• 23Z_.S Applicant/ Agent Information Print Name: %V11 — P_ ZEIM Z-EtS CQW5T?UQMCW INC . Mailing Address: S LAB OryDIDE 3oZ7 Phone: S- 9226 Email: MlCiarLgi ad Signature: g BY SIGNING BELOW YOU ACKNOWLEDGE THAT A BUILDING PERMIT MAY BE REQUIRED FOR THE SCOPE OF WORK LISTED BELOW. YOU MUST CONTACT THE BUILDING DEPARTMENT TO DETERMINE IF A BUILDING PERMIT IS REQUIRED. FAILURE TO OBTAIN A BUILDING PERMIT WILL RESULT IN A STOP WORK ORDER, DOUBLE PERMIT FEES, AND POTENTIAL FINES. BY SIGNING BELOW, YOU ALSO ACKNOWLEDGE THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE AND ACCURATE TO THE BEST OF YOUR KNOWLEDGE. Signature: Date: 1 Would you like to receive emails regarding is is Preservation and Community Planning within your community? Description of proposed work Completely describe the entire scope of work, including changes in material and color, and methods that will be used to accomplish the proposed work. For large projects an itemized list is required. Use the reverse side if necessary. f - IN a C l •?' % • . HISTORIC PRESERVATION BOARD - 300 S. Park Avenue - Sanford, Florida 32771-407.688.5145 - www.sanfordfl.gov/HP APPLICATION # FOR A CERTIFICATE OF APPOPRIATENESS Supplemental Information - Please use the space below to provide additional details regarding proposed work. Description of proposed work (continued from previous page): ONLY WORK SPECIFICALLY INDICATED ABOVE IS PERMITTED. ANY CHANGES TO THE BUILDING NOT LISTED ABOVE ARE NOT PERMITTED AND REQUIRE AN ADDITIONAL CERTIFICATE OF APPROPRIATENESS. Site Details Please use the space below to illustrate site details. HISTORIC PRESERVATION BOARD • 300 S. Park Avenue • Sanford, Florida 32771 •407.688.5145 • www.sanfordfl.gov/HP Property Record Card Oarlo,Wnnson,CFa ! Parcel: 25-19-30-SAG-03t 7 08-0060 A MR i Owner: BOLT VENTURES INC varesxAvn oHmA ! Property Address: 120 LAUREL AVE SANFORD, FL 32771 Parcel Information Value Summary, Parcel ! 25-19-30-5AG-0308-0060 Owner °BOLT i t l; II 2017 Working 2016 Certifiedo Values j ValuesVENTURESINC Property Address 1 120 LAUREL AVE SANFORD, FL 32771 i I Valuation Method Cost/Market Cost/Market i ! i_------- -- -- --- -- _.-_.._ --- - --- - I J ! i Number of Buildings 1 1 i IMailing316GOODLANDSTORLANDO, FL 32811 Subdivision i Depreciated Bldg Value 22,053 22,385 Name ; SANFORD TOWN OF Depreciated EXFT Value 4,879 4.879 j Tax District ! S3-SANFORD-WATERFRONT REDVDST 7 ------ -- - - ----- -- -- --- -- - --...--- -- i ; Land MarketValueMarket) 71,370 71.370 i DOR Use Code! 11-STORES GENERAL -ONE STORY i Land Value Ag Exemptionst-------------___..__-!-------------•----_-__ ______.-_-__•--•-_-----•---._---___._. ; j Just/Market Value " 98,302 98,634 r._...r-..-.-«.-_. R.... n..r.r.....rw...-...evva..«.........-e......u....t•w- 1 6 1 Q a r i' - I I 11 f i 8 Seminole County GIS I PortabilityAdj Save Our Homes Adj 1 Amendment 1 Adj j PSG Adj ji Assessed Value 0 $ 0 0 $ 0 0 $ 0 98, 302 $98,634 Tax Amount without SOH: $1,977.18 2016 Tax Bill Amount $1,977.18 I Tax Estimator Save Our Homes Savings: $0.00 i Does NOT INCLUDE Non Ad Valorem Assessments Legal Description 1 LOTS6 T08 BLK3TR8 TOWN OF SANFORD i PB 1 PG 61 Taxes Taxing Authority —__-- -- Assessment Value I Exempt Values Taxable Value Ii I Schools 98,302 0 98,302 City Sanford 98,302 0 98,302 j f I SJWM(Samt Johns Water Management) 98,302 0 98,302 County Bonds 98,302 0 98,302 1 County General Fund 98,302 0 . 98,302 Sales I Description - Date I Book Page Amount ual !QifiedVac/Imp j CERTIFICATE OF TITLE 10/1/2010 07457 0203 100 No Improved SPECIAL WARRANTY DEED 2/1/2008 06942 1106 275,000 No Improved WARRANTY DEED 7/1/2002 04450 1615 300,000 No Improved WARRANTY DEED 8/1/1994 02810 0859 66,000 Yes Improved WARRANTY DEED 3/1/1980 01272 1074 30,,500 Yes Improved i Land - Method - i Frontage p Units ! Units Price -- i Land Value SQUAREFEET — - - 14274 --- --_------------i AREFEE ---- ------------- $ 5.00 $71,370i Building Information I I 1 Description Year Built j Stories j Total SF Ext WallI Adj Value Repl Value Appendages Actual/Effective j I I 1 WOOD 1977/1987 BFAM/COLUMN 2 528 STUCCO WANOOD OR MTL $22,053 $33,163 Description — Area OPEN PORCH FINISHED 48.00` 48.00 i FFIINIEHEDRCH Permits j Permit # I Description Agency Amount . CO Date Permit Date — 00906 MECHANICAL - HEAT PUMP SYSTEM WITH DUCT WORK — SANFORD $4,300 4/4/2016 Extra Features Description I Year Built Units Value New Cost I j 4' CHAIN LINK FENCE 12/1/1977 72 115 288 f COMMERCIAL ASPHALT DR 2 IN 12/1/1977 3,150 1,147 2,861 I BLOCK WALL 12/1/1977 2,484 2,981 7,452 j CONCRETE WALKWAY 12/1/1977 566 566 I, i1,41511 j 6' CHAIN LINK FENCE 12/1/1977 29 70 174ii 2 5 C, A. f-; 13 f) C, 2 D' I V i 20,16 FOOTPRINT Parcel: 25-19-30-5AG-0308-0060 Building No.: 1 Page No: 1 U:-f: Co Legal DL5C!`,p1i011 Taxes 12 12 1st ROOF 2nd Root 1-1100 1-1100264St 264 sf 12 12 OPF OPF 418sl Y 48 St Sketch by Ap" f khafim* 1R'P.ANTY DEED' Print Friendly V p;x.T. A lo.; j r; t Ow3fl's:; 21 i 12 0 C 3 0C.0 1, 0 un;:,, Units P,:!,- L. i:id Y. A pp .1a 7 STUCCO'.,;.'A-0,1 22.C-53 C!. STUD.S. C-.- PCRCH Pviwits CO HE,W, PLj:,!P 0 1 SCPAP—IV-25--i X OSS Vleb.rup AWs— X MW Mavc %ad Mof; X KI — is x C 0 Q) data mapCfiannelLeoml—alm PkDMT( APP?Af: G '.;VROMX -WHEA-W f? OFFOUS ('APCMIFTImeN*Xrj, v-tis—h-k- Dmd-a 130CIMTuck oft, b-k-,k. AIM 1* MwsnmVia0 Start Map Download Fide Cap S— _o $I BV.k ADA :tt A , , PACD ... Id 011- Ilt c. metropcsr 14 d D.A G66gMW* 8.811059' Mg,-81.272458' > 1 1.1, 28.810818'bq, A1.27241' hdg. 349.9' dst 27.2m D"M M— THIS INSTRUMENT PREPARED BY: GRANT I`IiaLOY r SEI1 [h(OLE COUNTYYName: ZEES Construction Inc. Address: PO Box 471445 Lake Monroe, FL 32747 - CLERK OF CIRCUIT COURT & C:01'IF'TROLLER BK 1145 F's 1968 (•1F'ss ) CLERK'S 4 2017006154' NOTICE OF COMMENCEMENT RECORDED CifEES $1i17 11:'?4:1! lPt RECORDING FEES 1t1.C10 RECORDED BY hdevorra State of Florida County of Seminole Permit Number: _ Parcel ID Number: 25-19-30-5AG-0308-0060 The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available) LOTS 6 TO 8 BLK 3 TR 8 TOWN OF SANFORD PB 1 PG 61 LRO Lpt r,-6L GENERAL DESCRIPTION OF IMPROVEMENT: Reroof OWNER INFORMATION: Name: Bolt Ventures Inc. Address: 316 Goodland Street, Orlando, FL 32811 Fee Simple Title Holder (if other than owner) Name: CONTRACTOR: Name: Michael R Zent, ZEE'S Construction Inc. Address: PO Box 471445, Lake Monroe, FL 32747 Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section 713.13(1)(b), Florida Statutes. Name: Address In addition to himself, Owner Designates Section 713.13(1)(b), Florida Statutes. of To receive a copy of the Lienor's Notice as Provided in Expiration Date of Notice of Commencement (The expiration date is 1 year from date of recording unless a different date Is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART i, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true tot ester n dge and belief. ors Itts 0 efs Signature Owner's Printed Name Florida lalule 713.13(1)(g):' The owner must sign the notice of commencement and no one else may be permitted to sign in his or her stead." State of r100 d 4 County of 15u "i no If., . 7 The foregoing instrument was ack wledggeed before me this/ -7 day of - /u AZU . 20 by C( I -1 17 Who is personally known to me tJ Name of person making statement OR who has produced identification type of identification produ LORI A PERINA / MY COMMISSION N FF 130468 EXPIRES: August 28, 2018I)* Bonded Thru Notary Public underwriters Notary Signature