HomeMy WebLinkAbout2417 Whippoorwill CtCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
��
Documented Construction Value: $ D b�
I
.lob Address: � � oo r � 1 I I lam' Historic District: Yes ❑ No �,
Parcel ID: ?a) (}23 a - Residential a Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration® Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work: Y-eV o4--, 42-SC lWnn, --a i i a-, wm Mama
Plan Review Contact Person:
H
Title:
Phone: ��Cj3 Fax:�Email:".� �(�(�Qi�'�%�
Property Owner Information qmat Lpl'Yl
Name �W h) T(,t -w Phone: 4+54
Street: Resident of property? Les
City, State Zip: 2
i� Contractor Information
Name_lnT I Ui(1(i-e_ Q pa-1'r (\-n Phone: 46) quo 32 i/0
Street: I U 5 \(� Sn 4-A ,J Fax:
,,� f T
City, State Zip: 1 V ( ni -e V Rwl � F-- 3 L-ru? State License No.: c CS` ( —?:?0
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company:
Address:
Mortgage Lender:
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. I 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: 5t1 Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
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 informatio
be done ins
nce with all applicable laws regulating constructs and
Si ture O er/Ageat— Date t watur
Print OwnerBe is /A Name W Print o
�g
y&ature of Notary -State of Florida Date
+ptN+ Zkt, JOSEPH PAUL HORSCH n
t * My COMMMION # GG 08 W
EXPIRES: March 23, 2o21
��Of FLAP\ BOnded TM Bu*1 Norary Sef hm
Owner/Agent is Personally Known to Me or
Produced ID—K Type of ID F11D4.
of
I
and that all work will
a�--
JILLIAN S HARRIS
9,/i
' %T �,S*ate of Florida -Notary Public
Commission # GG 112296
x�.rYr �` tv1y Commission Expires
06, 2021
C&ftiffc"t$r gent is X 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: Occupancy Use: Flood Zone: _
Total Sq Ft of Bldg:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
# of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
THIS INSTRUMENT PREPARED BY:
Name: TOTAL HOME ROOFING VAI.l
Address: 165 W ST RD 434 Winter Srings. FL 32708
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number:
GRANT NALOYP SENIHOLE COUNTY
CLERK. OF CIRCUIT COURT & COMPTROLLER
PK 9090 Pg 1.126 (IPgs',
CLERK'S 2018027620
RECORDED 03/1:3/2018 11: 4° ° :I.;, All
RECORDING FEES "10.00
RECORDED BY
Parcel ID Number: 1 ) �V - 3 1 - S) 2-- n o L)-2,?j 0
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.
N OF PROPERTY: (Legal description of the property and street address if available)
GENERAL DESCRIPTION OF IMPROVEMENT:
re -roof ONLY
Ov
Na
Adi
Fee Simple Title Holder (if other than owner) Name:
CONTRACTOR:
37 Name: Total Home Properties DBA Total Home Roofing
Address: 165 W ST RD 434 Winter Springs, FL 32708
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:
In addition to himself, Owner Designates of
To receive a copy of the Lienor's Notice as Provided in
Section 713.13(1)(b), Florida Statutes.
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 COMMENQ&SMQRK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penaJifCs ot4rju/y, I declareAat I have read the foregoing and that the facts stated in it are true
to the be ofro edge and lief.
K .lam/
W INTQ "'--
wner's S n re m
Owner s Printed Name
Florida S ut 13.13(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 FLORIDA County of SEMINOLE
before me this OZ day of
The foregoing instrument was acknowledged}4
4#4-y,� , 20 1 %
in _
✓ �%� ` Who is
known to ❑
by tt V►t
personally me
Name of person making statement
OR who has produced identification 9 type of identification produced:
F LOL
�1rAY?v,.�,c JOSEPHPAULHORSCH11
* x MY COMMISSION # GG 086548
Not5ry Signature
�q EXPIRES: March 23, 2021
i"'*Of
DPP 6tx%W Thru 6W90 Notary Services
Date:
1 hereby nam, and appoint
of TOTAL i `ROOFING to be,", lawful
may.,
in fact to act for me and .ably to the
ent inr a
1'ti< �ernai#.
For vrk to 6e ppfoffned. at a loc on described as:
ParcflD::_2. -31, 0I d() • �� Z_o
Subdon
Owner of property and address:
LQ- -
Yvh'4goo
Arid to sign.,my naam and do afk things,necessary to this
P. �t
or : o.
(s^re a# wrtMed contractor)
The. fomg=V kwournent acknowle a
20_
ww :belie —Zmay,
of
*,ftber#:.DonMn; wft ,ls personally known to one.
State of Florida' ;
County of Se ranale
(Marla site)
�pv a ry Public Stets of Florida
T 3
_
ommis onn G1MA
ae 92res 1a1712021
is e�° :�o
CITY OF
Building & Fire Prevention Division
&.FORD RESIDENTIAL RE -ROOF POLICY & PROCEDURES
FIRE DEPARTMENT
PERMITTING REQUIREMENTS —NO PLAN REVIEW REQUIRED
THIS DOCUMENT (SIGNED) ALONG WITH AN ACCURATE AND COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK ARE
REQUIRED TO BE SUBMITTED AS PART OF YOUR PERMIT APPLICATION.
THE SCOPE OF WORK MUST INCLUDE ALL APPLICABLE FLORIDA PRODUCT APPROVAL NUMBERS FOR ALL ROOF
COMPONENTS THAT WILL BE INSTALLED ON THE PROJECT.
A PERMIT WILL NOT BE ISSUED WITHOUT THESE DOCUMENTS. COPIES WILL BE MADE TO POST ON THE JOB SITE.
*"PROJECTS LOCATED IN THE SANFORD HISTORIC DISTRICT WELL REQUIRE PLAN REVIEW AND APPROVAL BY THE
SANFORD HISTORIC PRESERVATION BOARD
INSPECTION POLICY & PROCEDURES
A FINAL ROOF INSPECTION IS THE ONLY INSPECTION REQUIRED FOR RESIDENTIAL (SINGLE FAMILY, TOWNHOUSE,
MOBILE HOME, APARTMENT AND/OR CONDOMINIUM) RE -ROOF PERMITS.
THE FOLLOWING IS REQUIRED TO BE PROVIDE ON THE JOB SITE:
• PERMIT CARD, POSTED IN A CONSPICUOUS AND WEATHERPROOF LOCATION
• COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK
• COMPLETED AND NOTARIZED INSPECTION AFFIDAVIT
• ALL FLORIDA PRODUCT APPROVAL AND CORRESPONDING INSTALLATION INSTRUCTIONS
(PRODUCT APPROVAL SHALL MATCH WHAT IS ON THE SCOPE OF WORK)
• DIGITAL PHOTOGRAPHS (MUST INCLUDE THE PERMIT NUMBER OR ADDRESS IN EACH PICTURE)
o EACH PLANE OF THE ROOF, SHOWING THE UNDERLAYMENT INSTALLED
o ROOF DECK NAILING PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER)
o ROOF DECK NAILS USED (INCLUDING A MEASURING DEVICE OR RULER SHOWING SIZE OF NAILS)
o UNDERLAYMENT PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER)
o DRIP EDGE & VALLEY ATTACHMENT (INCLUDING A MEASURING DEVICE OR RULER)
o SHINGLES INSTALLED, NAIL PATTERN AND LOCATION OF NAILS
• SKYLIGHTS (IF APPLICABLE)
o DIGITAL PHOTOGRAPHS SHOWING ALL INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL
o DIGITAL PHOTOGRAPHS SHOWING ALL REQUIRED FLASHING, PER FL PRODUCT APPROVAL
FAILURE TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULT IN �AFIT PROVIDED BY A FLORDA DESIGN
PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING FBCE E BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: / �z DATE:
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
11
JOB ADDRESS: J 1 J�J�
STRUCTURE TYPE: SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: OREPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): D�
*PLEASE NOTE. ONL Y 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED
ROOF VENTILATION: N OFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: OYES (j) NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
------------------------
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 (5)(4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
HINGLE
1 1 corn
FL# I b <Jf `T 4-1 (J
O METAL
FL#
0MODIFIED BITUMEN
FL#
OTORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
O OTHER:
FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IFAPPLICABLE**
ROOF SLOPE: O LESS THAN 2:12 O 2:12 — 4:12 O 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
O SHINGLE
FL#
O METAL
FL#
OMODIFIED BITUMEN
FL#
OTORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
0 OTHER:
FL#
Blanton, Deborah
From: Jillian Harris <totalhomejillian@gmail.com>
Sent: Tuesday, March 13, 2018 12:22 PM
To: Building
Subject: Contracts for total home roofing drop offs
.ofl Sprint L E 12:2 PM
' �= l t-4
BREVAE D COUNTY OFFICE
321,452-9223
ORANGE & SEMINOU COUNW OFFICE
407-960-3810
VOL S A COUNTY OFFICE
386-233-3244
DATE Qd,'
r: I c4. _ CCC1330489
PHONE:
P Dupe Cate taken to prerh Gt i e exter,�,r s6.r 9h� xtl 9anticG7C�1nR.
i
ip
JreIL•des ta#tor ro remr3vw exis:ing =f and Itauf off,
C�
includes ®ulapster. Roil; off dumpztef for Dauer driveways_
�
Includ s nspeallrcg derjc fox darnaae and M(Mil:ng to cOd a With SID ring shank nails,
tnpludes s .vfrt 90W5, soffit, f=fa an eK1155m, homne (,eme damage m;#Y occur in construction).
Ind;uael rep$ zing radRa venom,
Inci*sdes repradV eidsttng drip edp in choice of rolwr. DRIP EDGE COLA: iNTZ I .
includes Y4" roofing mllctcd nO5.
Includes installing; ntw shigtes In d%okeof Color, SWINGLE COLON AmA, 4Q-,I< 1w,
Includes replacing.1rl Lead 21w= nd eowt �,erti5 ('does nattnelude gas reiazed veins).
Include& new gal'Yanized mini irr all vatljaVL
��'j
V
Includes Starter Shin& and WdZtCap per Coda.
Incluudpi ol�taicahng and posting permit With Ioc7t jurisdiction
tndud _, " ' Ca •v svrC a o13 ice antn r Wtters xnAb2uling awAy deGrl3:
MATEWAL ARCH nECf'lIMASPkALTLIFETLIVE941MG10 130h+PH
�i Ci
UHQFli1.}4METIT rP.EEL,,'& STICK 2a&A ^"° 1 y. r�rr ;A a:t .
_ •.. _wJ
CITY OF
s
SjkNFORD Building & Fire Prevention Division
FIRE DEPARTMENT Re -Roof Permit Card
PERMIT NO. / 8 0* / 3 Y 3 ISSUE DATE: O3 / 3s
CONTRACTOR: Qr/*
JOB ADDRESS:k)hJ"J0A000e&01*11 CI�
TYPE OF WORK: 0& && 9
PROTECT FROM WEATHER
• Post this Permit and all required documents in a conspicuous place outside
• Digital Photographs are required - please follow re -roof policy and procedures guide
• All trash, debris and dumpsters must be removed from job site at final inspection
• Permit expires six (6) months from date of issue
ROOF
INSPECTION TYPE APPROVED REJECTED INSPECTOR
FINAL ROOF F I I
FAILURE TO FOLLOW THE RESIDENTIAL RE -ROOF POLICY & PROCEDURES WILL RESULT IN A FAILED INSPECTION, A RE -INSPECTION
FEE AND MAY REQUIRE AN AFFIDAVIT, SIGNED AND SEALED, FROM A REGISTERED FLORIDA DESIGN PROFESSIONAL
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.
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. FBC 105.3.3
REVISED: 4-17 Inspection Line 407.792.6069 or 855.541.2112
TO SCHEDULE AN INSPECTION:
• Dial 407.792.6069 or 855.541.2112
• Provide the items,requested during the message
• The type of inspection requested must be scheduled under the appropriate permit type
• Follow the prompts
PLEASE NOTE:` Inspections scheduled by.5:00 p.m. will be conducted the
next business day. If you experience difficulty, please call 407.688.5150
Monday - Thursday 7:30 am - 5:30 pm for assistance.
AUTOMATED INSPECTION SYSTEM CODES
Final Roof Inspection Code III
Inspection Policy & Procedures
A Final Roof Inspection is the only inspection required for Residential
(Single Family, Townhouse, Mobile Home, Apartment and/or Condominium) Re -Roof Permits.
The Following is required to be provide on the job site:
• Permit Card, posted in a conspicuous and weatherproof location
• Completed Residential Re -Roof Scope of Work
• Completed and Notarized Inspection Affidavit
• All Florida Product Approval and Corresponding Installation Instructions
• (Product Approval shall match what is on the scope of work)
• Digital Photographs (must include the permit number or address in each picture)
o Each plane of the roof, showing the underlayment installed
o Roof Deck Nailing Pattern & Spacing (including a measuring device or ruler)
o Roof Deck Nails used (including a measuring device or ruler showing size of nails)
o Underlayment Pattern & Spacing (including a measuring device or ruler)
o Drip Edge & Valley Attachment (including a measuring device or ruler)
o Shingles installed, nail pattern and location of nails
• Skylights (if applicable)
o Digital photographs showing all installation components, per FL Product Approval
o Digital photographs showing all required flashing, per FL Product Approval
Failure to follow these specific guidelines will result in an affidavit provided by a Florida
Design Professional (Architect or Engineer), certifying FBC code compliance -by personal inspection -
REVISED: 04-17 Inspection Line: 407.792.6069 or 855.541.2112
FIRE INSPECTIONS CITY OF SANFORD
407.562.2786 $UILDING & FIRE PREVENTION
BUILDING INSPECTIONS 300 N PARK AVE
855.541.2112 SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
` ------------------------------------------=---------------------------------
Page 2
Application Number . . . . . 18-00001343 Date 3/13/18
Property Address . . . . . . 3417 WHIPPOORWILL CT
Parcel Number . . 07.20.31.512-0000-0230
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . . WIPPOORWILL
Property Zoning . . . . . . . SINGLE FAMILY
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1037753
Permit pin number 1037753
----------------------------------------------------------------------------
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
----------------------------------------------------------------------------
1000 111 BL03 FINAL ROOF / /
tf
CITY OF °
&�FORD Building & Fire Prevention Division
RESIDENTIAL RE-ROOFAFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT#: `9). 4- ADDRESS: 3ALq 1fk3h0 Yl i / et. -
I bce+ CA 'AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTOR, ENGINEER, ARCHITECT, OF F.S. CHAPTER 468 BU112-DING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
FOREGOING INFORMATION IS TRUE AND ACCURATE AND THAT ALL ROOFING COMPONENTS LISTED ON THE SCOPE OF WORK AT THE
ABOVE REFERENCED ADDRESS HAVE BEEN INSTALLED IN ACCORDANCE WITH THEIR PRODUCT APPROVALS AND ALL APPLICABLE CODE
REQUIREMENTS - SPECIFICALLY FLORIDA BUILDING CODE, EXISTING BUILDING. IN ADDITION I CERTIFY THE INSTALLATION MEETS ALL
REQUIREMENTS FOR SECONDARY WATER BARRIER AND NAILING OF THE ROOF DECK, IN ACCORDANCE WITH THE HURRICANE RETROFIT
MANUAL REQUIREMENTS (BASED ON F.S. CHAPTER 553.844).
LICENSE #: C- - 1 33o
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE:
(MUST BE SIGNED BY LICENSE HOLDER
A FINAL ROOF INSPECTION IS REQUIRED:
DATE: /,_1 118
THIS SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITE AT THE TIME OF THE FINAL ROOF INSPECTION,
ALONG WITH DIGITAL PHOTOGRAPHS OF EACH PLANE OF THE ROOF SHOWING IN DETAIL ALL COMPONENTS (DECKING,
UNDERLAYMENT, FLASHING, DRIP EDGE ATTACHMENT) WITH THE PERMIT NUMBER OR ADDRESS CLEARLY MARKED ON THE DECK
FOR EACH INSPECTION. THE PHOTOGRAPHS MUST INCLUDE A RULER OR MEASURING DEVICE TO CONFIRM ALL NAIL SPACING AND
OVERLAPS, INCLUDING DRIP EDGE AND VALLEY FLASHING. PLEASE REFER TO THE RE -ROOF POLICY AND INSPECTION PROCEDURE
PAPERWORK FOR FURTHER EXPLANATION OF ALL REQUIREMENTS.
**FAILURE TO FOLLOW ALL REQUIREMENTS WILL RESULT IN A FAILED INSPECTION, A RE -INSPECTION FEE AS
WELL AS REQUIRING A DESIGN PROFESSIONAL (ARCHITECT OR ENGINEER) TO CERTIFY, BASED ON PERSONAL
INSPECTION, THE INSTALLATION OF ALL ROOFING COMPONENTS.
STATE OF FLORIDA COUNTY OF (3 1 I I)06 UC-
Sworn to and Subscribed before me this day of 20 I 10 by:
Who is'af_rsonally Known to me or has ❑ Produced (type of
i ficat nn)
S' atu e o o a
to a of Florida
Print/Type/Stamp Name
of Notary Public
as identification.
JILLIAN S HARRIS
�`<PPV pLb �i
_Stata,pf.�FilQrida-Notary Public
Commission # GG 112296
i P 8 /
�F FE OF FI°P�` My Commission Expires
"""" June 06, 2021