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HomeMy WebLinkAbout708 Briarcliffe St-,�/1 I CITY CF Siki4FORD MAR 15 2018 FIRE tP#;RTiV ENT }y J� Job Address: 708 BRIARCLIFFE ST SANFORD FL 3277.3 Historic District: Yes❑No❑ Parcel ID: Residential Commercial❑ Type of Work: New❑ Addition❑ Alteration[] Repair❑ Demo❑ Change of Use❑ Move❑ Description of Work: REMOVE AND REPLACE ROOF WITH SHINGLES Building & Fire Prevention Division PERMIT APPLICATION Application No: ! F-9 Documented Construction Value: $ 7,765.00 Plan Review Contact Person: Title: Phone: Fax: Email: Property Owner Information Name MARY DIXON Street: 708 BRIARCLIFFE ST City, State Zip: SANFORD FL 32773 Phone: 407-416-2267 Resident of property? : YES Contractor Information Name PRO ROOFING & AS.SOCITES , INC Phone: 407-542-5903 Street: 3024 KANANWOOD CT SUITE 1008 Fax: 407-542-8790 City, State Zip: OVIEDO FL 32765 State License No.: CCC1328416 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: 61h Edition (2017) Florida Building Code Revised: January 1, 2018 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 information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zonin 'am V, � N ik Q Signature df Owiier/Agent Date Signature of Contractor/Agent Date Owner/Agent's N Date %RE�SSJ�G8 179751 2022 anuary 28, 2022 Bonded Ttuu Notary Public Underwriters ELMER CAMPOS Contractor/Agent' -W 60MMISSIM# GG 179751 EXPIRES: January 2.8, = Bonded Thiu Notary Public lhxJerwriters Owner/Agent is Personally Known to Me or Contractor/Agent is L"' Personally Known to Me or Produced ID Type of ID TA n L-. 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: Flood Zone: Min. Occupancy Load: # of Stories: New Construction: Electric - # of Amps Fire Sprinkler Permit: Yes ❑ No ❑ Plumbing - # of Fixtures # of Heads ,_ Fire Alarm Permit: Yes ❑ No ❑ APPROVALS: ZONING: UTILITIES: WASTE WATER: ENGINEERING: COMMENTS: FIRE: BUILDING: Revised: June 30, 2015 Permit Application 002 11 PIMROOFING �,. +�'.1 n1 N.A. MUM YLJ NL' $!'l�I•de'P` I �7�4.f1� '$�.iP�', P.reti��,ikN�i'�J�,I? t krawl � � a *0-.tits CUSTOMER ADDRESS SANFL ON CLI FFESTRD, FL 32773 MINOLE ROOF TEAK -OFF: 01 1 Layer shingles L) Single Ply Flat Roof 4 Felt Underlayment ❑ 2 Layer Shingles Gravel Roof Other I 2 It* lu,d. >�r� w�vwcr`vn***fttag.c+am� Ft 90 3 °°trees PROPOSAL NUM: PRO-77537862583 I Date: - - Phone, (407) 416-2267 Cell: Email; DDIXWNDY@AOL.COM R OF VENTILATION: Aluminum Ridge Vent_.____ft. Color: ❑ Baffled Shingle over Ridge Vent . _-- ft- Off•Ridge Vent(s): W 4 ft. Qty: 2 Color: WOOD REPAIR: W, Inspect Roof Deck for Damaged Sheathing ❑ 6 ft. City _ — color: P'iWER Re-Nail Entire Roof Deck Up -To Code VENT: ❑ Electric Exhaust Fan: city:,.__ Price: LI Plywood sheathing replaced at 60.0o per sheet_ ❑ Solar Powered Exhaust Fan: 4ty;_ Price: Trust, fascia and wood boards will be replaced at "(Electfical work not included.) 6.00 per linter foot. FfIMNEY AREA' Other: ]] New flashing b Replace existing flashing If needed. m"ry— -- FLAT ROOF SYSTEM: Build Chimney Cricket Price: F-a Torch Dawn Single Ply ❑ 75 Ibs Fiberglass Underlayment ❑ Remove Chimney Price: -- ---• NEW ROOF FLASHINGS: -•..--. SYLIDHTS: LJ New Skylight . ❑ Reuse existing Skylight 16" Flashing on; W Roof Valley(s) ❑ Flat Roof Pitch Change 2 x 2: Price: 4 x 2: Price: City. Plumbing boots Vents: 1.5"— 2"'3" 4"" Other: Price - Gooseneck Gooseneck Vents: 4" _ 61' 10.1.,,.__. Type of Skylight: -- Color: _ ❑ Self flashing ❑ Curb Mounted NEW GALVANIZED DRIP EDGF: W 2 1/2 Face installed around entire perimeter of roof ❑ Insulated Glass a Polycarbonaite Dome PROPOSAL NOTES: New skylight installations include interior work; wood frame, dry wall, paint and labor. Labor charge: ea. PLEASE SEE ITEMIZED PROPOSAL BELOW. PLYWOOD WILL BF CHARGED AT$60 PER SHEET AND $6 PER FT OF bIMEN%NA6 WOOD. PRICE INCLUDES 3 TAi3 SHINGLES. FOR ARCHITECTuRAL $rIIN(5LES Wll t BE $215 ADDITIONAL 10 THE TOTAI..AI 0VW. CITY I DESCRIPTION �w Removes tear off, haul and dispose Qf comp shingle I— — __ Re -nail of roof sheating-complete re -nail $0.23 X 3-tab $44,99 X Z4 Squares 70 SF Drip Edge $2.89 X 250 LF 1 Valley Metal $5_89 X 37 LF —1 R&R Flashing -pipe jack split boot $56.79 X 2__ 1 R&R Roof Vent -Turtle Type -Metal $52,25 X--- 1- Roofing felt-30 Ibs $38,95 X 24 Squares 1 Roof Vent -off ridge type-4" $121.61 X 2 1 Single Axle dump truck -per load -including dump fee 1 3 Tab Shingles Including Waste $137.55 X 26 Squares 79,76 1 81,079,76 $552,0_0 $552.00 $722.50 $217.93 $113,58 — $722.50 $217,93 $113.58 $156,75 $156.75 $934.80 _ $934.80 $243.22 $167.99 $243.22 $167,99 $3,576,47 .. ,.1 $3,576.47 02/lb 72Uiu 1llur 'HHEN 4 41J'eb428'r4-1J NU. bb2 Aij qTV pESCRIP71ON TOTAL ACCEPTANCE OF PROPOSAL L $7,765.00 The above specifications, prices and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined herein_ it payment is made with a credit card, there will be a 2% increment added to the total sum of the balance due. Any alteration or deviation from above estimate involving extra tosts will become an extra charge item over, and above this agreement. Any wood used to oerform repairs will be charged at the above ouacted rate, Payment Schedule�U on Completion Stan pate: .,_ __ Completion bate: CP_ y- -�� i J" 111812018 ut orized Igna re pate Pro Roofing & Associates Date RD""N &15115 acru'lli, ES DONE RIGHT I RAIN TIGHT, GUARANTEED 3024 Kananwood Ct., #1008 Oviedo, FL. 32765 P 407-542-59W F 407-542-8790 Mary Dixon PROPOSAL t2,),"' E' SWER - aAL FL ROOPIN45 CONTRACTOR I #CCC1328416 888-817-6787 1617 Ridgewood Ave Ste D Daytona Beach. FL 32117 www.cfproroofing.com 708 Briarcliffe St Sanford FL 32773 Name Address 0 1, toe ing eCo i56166tidni. �i V • Dnp"Edge Color S6116di6fi- Regards, &eniaf (5:Npas Administrative Assistant Pro Roofing & Assoc. Main Office: 3024 Kanawood Circle Suite #1008 Oviedo FL 32765 iessica@cfproroofing.com Office: 407-542-5903 x 101 INDTNIf I -NaWA X a/g, �h�n� le,� Permit Number: 11111111111111111Folio/Parcel Identification Number; 01_ZQ„3 _-� PrFe ared by; EDRIEL RODRIGU� 0 5041100- �11�llJJlJ1 turnto... o. PRO ROOFING 0070 GR4NI /1,4LOY, s G & ASSOCIATES INC CL ER,K OF r- . ' Er�r�vc � NOUN rY 30241(ANANWOOD000RT,S`u�TEloos oviE�oFL 32765 �� �'17v �h�Urr rOUr �` farrFrRoLLER GLERK'g Fg 1139 f1F'3-J NOTICE OF' COMMENCEMENT ir �O-11,12 484� h'ECDRGEI � i�i3lr_if /2� i j 8 t i t � i1E : �.7 F't4 State of countyof RECORDMG FEEa $fi_i.00 TheeofFlorida,Flida hereby SEMINOLE RECORDED By undersignedy gives notice that improvement(s) will be made to certain real property, and in accordancewithChapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Description of property legal description of the property, and treet address if available) W 45 FT OF LOT 7 & LOT g (L 30 FT) i -\ .:�> 2pagAMW%bRQ"PdA CI 6%6i]64"FORD, FL 32773 TT - REMOVE AND REPLACE ROOF WITH SHINGLES 3. Owner information Name: MARY DIXON Address 708 BRIARCLIFFE ST, SANFORD, FL 32773 Interest in Property OWNER 4. Fee Simple Title Holder (if other than owner shown above) Name: N/A Telephone Number: Address 5. Contractor Name: PRO ROOFING & ASSOCIATES INC. Telephone Number: 407-542-5903 Address 3024 KANANWOOD COURT SUITE 1008 OVIEDO FL 32765 6. Surety (if any) Name: ' Address N/A Telephone Number: ,-DCOPY GRANT MALOY ^` 7. Lender (if any) Amount of bond $ RK OF THE GI Name: AND Telephone Number: SCO Address N A EMINLE C LINTY, f40 A 8. Persons within the State of Florida designated by Owner upon whom notices or other doc ate may a se O V C� provided by §713.13(1)(a)7, Florida Statutes. Name: Address Telephone Number: 9. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as provided in §713.13(1)(b), Florida Statutes. Name: N/A Telephone Number: Address 10. Expiration date of notice of commencement (the expiration date is one upar from *ha 4�f_ -IF alifereni ciate Is -. . ---. —...6 vn ' a - --- -- - wa acecvies: unaer penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. 11. Si natur of ner Signatory's Printed Name/Title/Offlcei (or Owner's Authorized Officer/Director/Partner/Manager §713.13[ll[d]) This document was acknowledged before me this ZO day of fe-6 , 2018 by yl&a v' who is personally known or produced F:._b as identification. EDWARDO OTERO Signature of Notary Public — State of Flor -• ; o ary u lic State of Florida «o� Commission # GG 003479 %',FOF.���';:•'� My Comm. Expires Jun 28, 2020 L SEMINOLE COUNTY and/or CITY OF SANFORD DATE: 2/27/2018 I hereby name and appoint: ' A- an agent of: PRO ROOFING & ASSOCIATES, INC. (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): ❑ All permits and applications submitted by this contractor. /The specific permit and application for work located at: 708 BRIARCLIFFE ST, SANFORD, FL 32773 (Job Site Address) Expiration Date for This Limited Power of Attorney: DECEMBER 31, 2018 License Holder: ELMER A. CAMPOS State License #: CCC1328416 Signature of License Holder: State of Florida County of SEMINOLE The foregoing instrument was acknowledged before me this 1 5 day of 0�A rN k20 1 by ELMER A. CAMPOS who is personally known to me and did not take an oath. WITNESS my hand and official seal this / S Sig t5reof ary Public — "State of Florida i yie����� f OZIEL HERNANDEZ Notary Public - State of FlJ2020 •_ `ac Commission# FF 9903 '4•F OF FGGP �� My Comm Expires 9, NOTARY SEAL day of 192.Cv--� , 20 1� (Printed Name.) Commission No. FFg9 0 3�,43 State of FL. County of SEMINOL My Commission expires: Sq a© Rev.12/13 City of Sanford Building Division Residential Re -Roof Inspection Policy & Procedures 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 will 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 r t in an affidavit provide by a Florida Design Professional (architect or engineer), certifyin code co pli ce y pe sonal inspection. CONTRACTOR (OR OWNERBUILDER) SIGNATURE: C�%�"/ DATE: i IE JOB ADDRESS: PERMIT # City of Sanford Building Division Residential Re -Roof Scope of Work 'Y STRUCTURE TYPE: ® INGLE FAMILY RESIDENCE/TOWNHOUSE Q MOBILE HOME O APARTMENT/CONDOMINIUM RE -ROOF TYPE: REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS) O RE-COVER (NEW ROOF INSTALLEDCOVEREXISTING ROOF) DECK TYPE (PLEASE SPECIFY): �T� \ C "PLEASE NOTE: ONLY I00 UARE FEET OF THE EXIS NG D K IS PERMITTE TO BE REPLACED"* ROOF VENTILATION: OFF -RIDGE Q RIDGE Q SOFFIT OPOWERED VENT Q TURBINES SKYLIGHTS: O YES (!(NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #: MAIN ROOF AREA ROOF SLOPE: Q LESS THAN 2:12 Q 2:12 — 4:12 V 4 12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL Q SHINGLE FL# ` "L Q METAL FL# O MODIFIED BITUMEN FL# Q TORCH DOWN FL# QINSULATED FL# Q TILE FL# ee \\ 0 THER: FL# ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) "IFAPPLICABLE" ROOF SLOPE: O LESS THAN 2:12 0 2:12 — 4:12 O 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL O SHINGLE FL# Q METAL FL# O MODIFIED BITUMEN FL# Q TORCH DOWN FL# QINSULATED FL# Q TILE FL# 0 OTHER: FL# ray �.w City of Sanford ..3 Building and Fire Prevention RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT #: �(( ADDRESS: 77LX I C - / L �% �!� AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR ROOFING ONTRACTOR, NG ER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING 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 #: COMPANY / CONTRACTOR: CONTRACTOR SIGNATURE: (MUST BE SIGNED BY LICENSE HOLDER.OR A FINAL ROOF INSPECTION IS REQUIRED: DATE: ` 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%(�/� Sworn to and Subscribed before me this. day of 12220/ 8 by: ral22 S Who is",g)Personally Known to me or has ❑ Produced (type of identific _ as identific �APrio����� ti ' Signs Cre of Notary Public M�SStO/y • • s .•GO . J�y2gO�P�• : `'o� State of Flori a _� g� ' / S Z :y . #IGG 178567 Print/Type/S amp Name of Notary Public 5 � •.'a eo j'py?.A"'61ir woo- '•per P, City of Sanford Building and Fire Prevention RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT#: /61— /3 7 ADDRESS: 4f � S Sp��" _-VAL I , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR ROOFING CONTRACTOR, ENGINEER, ARCHITEC , OF F.S. CHAPTER 468 BUILDING 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 4: COMPANY / CONTRACTOR: CONTRACTOR SIGNATURE: (MUST BE SIGNED BY LICENSE HOLDER OWNER/BUILDER) A FINAL ROOF INSPECTION IS REQUIRED: DATE: 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 Sworn to and Subscribed before me this day of 20 k"� by: Who is ❑ Personally Known to me or has ❑ Produced (type of jidentj as identification. Signatur to li State of Florida �M; EXPOSITO +rAg, # W C61;WIOM # GG 179751 EXPIRES: January 28, 2022 of d�°• Bonded Ifni Notary Public ftermtors Print/Type/Stamp Name *_ of Notary Public