Loading...
HomeMy WebLinkAbout108 W Coleman CirCITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: l — 40- Documented Construction Value: $ "96 U(X) Job Address: Historic District: Yes ❑ No LJ Parcel ID: lol^c��" 'i�'" �� � Residential L?C- ommercial ❑ Type of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑ Description of Work: � ��� ; , tq Plan Review Contact Person:h-�1 i �FLIL� Tit1e:�YQ�-� Phone qcn" Fax: Email: Property Owner Information-' Name tea \ 1`- 1CJ1 Phone: LAcn — R,�Sz;� Street: lQZ> Lgr • _nn^^ YYY._Jl��'1 �� Resident of property? : OkDV Er City, State Zip:L�'�U)[b R' zi�_�n_J Contractor Information Name t - % Phone: LAM —(Q'!5(D7T Street: 1 �3X 11 Fax: City, State Zip: '0 1 n�C-�n _ 1'�. ?-�.-i"� State License No.."W 2. 1• Name: Street: City, St, Zip: Bonding Company: Address: Architect/Engineer Information Phone: Fax: E-mail: 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: 511, 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 information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Ign of tary-State of Florida Date ign a of ta. SAMUKL NiOOTY •i MY COMMISSION # FF953572 uar 25.2020 '? PIftES Jan Y :•• pry' VIM .Otr 14GlI SY Owner/A or Contra Produced ID Type of ID Produced ID Name of Florida ! / Date SAMUEL MOOT'Y MY COMMISSION # FF953572 EXPIRES January 25. 2020 _ to Me or Type of 1D 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 APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: FIRE: Flood Zone: # of Stories: Plumbing - # of Fixtures Fire Alarm Permit: Yes ❑ No ❑ WASTE WATER: BUILDING: Revised: June 30, 2015 Permit Application r-- -' - -- . • -- - TNtSTRUWNT EPARE�Y: Name: Address' l , idl+-n-------7�5`� NOTICE OF COMMENCEMENT State of Florida County of Seminole � Permit Number, Parcel 10 Number: 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 PROPI�FTY: (Legal description of the properly and street address it available) GENERAL DESCRIPTION OF IMPROVEMENT; lip OWIJER FOR ATIO� Name:• Address Fee Simplo Titla Neldar (if other than owner) Name i� Address: ^ � 1 • , . , - - - - % ' Persons within the State of Florfds Dasignated by Owner upon whom notice or other documents may be served - as provided by Section T13.73(t)(b), Florida Statutes. Name. Address: In addition to himself. Owner Designates To receive a copy of the Lienor's Notice as Provided in Section 713.13(1)(b). Florida Statutes. Expiration Date of Notice of Commencemont(The expiration date is 1 year from date of recording Unless a different date is specified) WAANING 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 013TAIN 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 to the beat of my knom4pd"nd belief. igaw- A Owner's Primed Name Florida Statute 713. t3f1)(g):.. The own /—t sign the notice of ppmmer24+nant and no one also may be pea -tined to so in his or her Lead' State of County Of The foregoing Instrument was acknowledged before me this day of A 2 1 by , od �tAi�\! Who Is personalty known to me Name of W,%olmaking statement OR who has produced identification ❑ type of Identification produced: .,SAMUE � is SAMUEL 'A?o Y tilt' COMMISSION A FF9$3$72 f d. ••.,o.� a:''• EXPIRES January 25. 2020 Notary signature dan,x GRANT MALOY, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL CLERK'S # 2018053845 BK 9131 Pg 0463; (1 pg) E-RECORDED 05111/2018 01:12,34 PM 10.00 jv'rlt ttvf� PROPOSAL SUMMT-TFD TO: PHONIC . Y t J IlAn NAME HY JOIN RAMM 7 STREET NA-ll STRBETT Cot" A CITY CITY STATE. Sun 'prr A- We hereby submit specificatiOns and eWhwteasubjvd toall term aadmffiti"s- as W forth lie x0f. affAMUM, ff E_M$ GRECK W, to Remove old roofing_ r I Install new felt - 15 1b. 30 lb. — 0 install new eve -drip - pAv— alum color_ GUVYCr_ 1i Install new valley- metal— 0 InstaTnew load. boots— ED Install new range vent cap El WWI 4 it. off ridge, vent UUMUerULV0Utb_C0SL-p.Avent • Install ridge vents number of vents__ color— cost per vent • install new Bashing - wall chimney • Rework Bashing - wall , chimney- 11 Reinstall tkisting vents — 2—Install roll roofing - color- 0 Install buitd-up roof - jambe. .of plys_ fiberglass, organic C-i ,Install rock - river rock_ color— slag_ .. other- 0 1mswHbald-top roof 'wit.h. lberglass felt plys�__ coating o Install one ply system - coafing__ color E, install Dew gravel -sop - galv_ aIum, poppe install-liew meal roof c olor— gadge� stall new shingle - fibergWs_ other — a LawayAdxoofingondmaterials .0-cleart up grounds • Reroof over old roofing • Install insulation board -.t),pc. size 0 Install new skylight - number type size Z_�_Ue L'j'MVG WariVAY -number of years-71-V 'D Workmanship warranty - number of yem-2 0 Extra cost, wood repairs -1abor per man. hour U.L& plus materials 01 Appmximate cost for wood repairs $ lk 1 47 K All proceeds.from insurance insuranc conipany, become property.of lest 01079V00049-Mc. Home (h"er has 72 hours from date of signature to nitllify. contrza VdthlWo %_&R�Mc, t. Authorized,Sipature. Accweb: The above prim.. specifications and wnditions are Date: g� —Wn satisfactory and -am hereby accepted you are authorized to do die work as specified. Payment Will be madewheiisbPairs are romPleted. Signature; West orange is-notresponsible for. daniaged or cracked driveways. Signature: CONIDMONS All inatenal is guaranteed tobeas specifidd. All work into be c6inpletid in a workmanlike rnanher aoeordiag to.stsrWftid:ptaatictis. AnY alteration Or deviation from specifications involving extra costs Witt he-executedorily up -on dxtM:chiW over andabove the estimate, All agreements condkObt upon qftikt%:4c6dents:o.r:dela.Ys b"&Our contmi..Ownerto Mry fi_e wpa&- Our workers are fWlv covered by Wo4moitis Compensation 1n5m-Ai'= and other necessary itistimace Building & Fire Prevention Division Re -Roof Permit Card PERMIT NO. e ISSUE DATE: CONTRACTOR: I 0 JOB ADDRESS: TYPE OF WORK: ®1� PROTECT FROM WEA194ER • 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 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 FIRE INSPECTIONS CITY OF SANFORD 407.562.2786 BUILDING & FIRE PREVENTION BUILDING INSPECTIONS 300 N PARK AVE 855.541.2112 SANFORD FL 32771 DRIVEWAYS -SIDEWALK 407.688.5080 ------------------------- A . . Application Number . . . 18-00002240 Date 5/15/18 Application pin number . . . 411200 Property Address . . . . . . 108 W COLEMAN CIR Parcel Number . . . . . . . . 12.20.30.502-0000-0250 Application type description ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . . . . SINGLE FAMILY Application valuation . . . . 8800 ---------------------------------------------------------------------------- Application desc reroof/shingles noc on file ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ OWNER --------------------- Structure Information 000 000 ---------------------- Roof Type . . . . . . . . . FIBERGLASS SHINGLES ---------------------------------------------------------------------------- Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 1050897 Permit pin number 1050897 Permit Fee . . . . 103.00 Issue Date . . . . 5/15/18 Valuation . . . . 8800 Expiration Date . . 11/11/18 Qty Unit Charge Per Extension BASE FEE 40.00 9.00 7.0000 THOU BLDG PERMIT -CC APPRVD 9.27.10 63.00 ---------------------------------------------------------------------------- Special Notes and Comments All projects within the City shall use WastePro for debris removal. Please contact WastePro at 407.774.0800. Normal hours for inspections are from 7:30 through 4:30 Monday through Thursday. Please be aware you must contact the Building Official to schedule a Friday or after hours inspection. This is required since not every inspector is licensed to do every type inspection. Communication is the key, so please contact the Building Official if you have any questions at 407.688.5058 or at dave.aldrich@sanfordfl.gov ------------------------------------------------------------------- Other Fees . . . . . . . . . 01-APPLCTN FEE -BUILDING 25.00 01-BLDG PLAN REVIEW 27.00 01-BLDG DCA SURCHARGE 2.00 ? 01-BLDG DBPR SURCHARGE 2.33 --------------------------------------------------------------------------- Fee summary Charged Paid Credited -------------------- - Due i --------------------------- Permit Fee Total 103.00 .00 .00 103.00 I Other Fee Total 56.33 .00 .00 56.33 Grand Total 159.33 .00 .00 159.33 ---------------------------------------------------------------------------- FAILURE TO COMPLY WITH MECHANIC'S LEIN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS. NOTE: ALL FEES MUST BE PAID PRIOR TO C.O. BEING ISSUED. NOTE: PLEASE BE ADVISED ALL PERMITS MUST BE INSPECTED. CITY OF SANFORD # CUSTOMER RECEIPT +�** Oper: BLANDA Type: OC Drawer: 1 Date: 5/15/18 01 Receipt no: 124041 Year Number Amount 2018 2240 108 W COLEMAN CIR SANFORD, FL 32773 BP BUILDING PERMIT RECEIPTS $159.33 AC 011850 Tender detail CC CREDIT CARD $159.33 Total tendered $159.33 Total payment $159.33 Trans date: 5/15/18 Time: 16:06:01 CITY OF PERMIT # 1 O '��`►� Building & Fire Prevention Division �I CtEPRT9 rI+I1 RESIDENTIAL RE -ROOF SCOPE OF WORK JOB ADDRESS: ci STRUCTURE TYPE: OISINGLE FAMILY RESIDENCE/TOWNHOUSE 0 MOBILE HOME O APARTMENT/CONDOMINIUM RE -ROOF TYPE: J REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS) O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF) DECK TYPE (PLEASE SPECIFY): �' nl 111�I1 "'PLEASE NOTE: ONLY 100 SQUARE FEET OF DECK IS PERMITTED TO BE REPLACED'" ROOF VENTILATION: OFF- IDLE ORIDGE OSOFFIT OPOWEREDVENT SKYLIGHTS: O YES NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #_ MAIN ROOF AREA ROOF SLOPE: O LESS THAN 2:12 (362:12--4:12 0 4:12 OR GREATER OTURBINES TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAAL, SHINGLE \ FL# _ F- O METAL O MODIFIED BITUMEN 0 TORCH DOWN FLU FL# FL# OINSULATED FLY O TILE OTHER: p 1-� I. Q ^� FL# ROOF EXTENSIONS (PORCHES PATIOS ETC.) **IFAPPLICABLE" ROOF SLOPE: O LESS THAN 2:12 0 2:12-4:12 0 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL 0 SHINGLE FL# O METAL FL# O MODIFIED BITUMEN FL# O TORCH DOWN FL# O INSULATED FL# 0 TILE FL# 0 OTHER: FL# ii'fY OF . Building &Fire Prevention Division NANFORD 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 ALI, 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 TILE 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 AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING kBC CODE COMPLIANCE BY PERSONAL INSPECTION. CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE: LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date:-_ 1 hereby na1 an agent of: 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): ❑ The specific permit and application for work located at: (Street Address) Expiration Date for This Limited Power of Attorney: License Holder Name: State License Number Signature of License f STATE OF FLOPUDA COUNTY OF The foregoing instru ent wa cknow dged before me this ( day of , Qj 201 by (�� who is t1fersonaly known to me or ❑ who has prod ed as identification and who did (did not) take oath. S' atu�re F ?tar l�L two0iY 0 • MY COMMISSION 9 FF953572 Print or type name EXPIRES January 25. 2020 Ah;,,A_a•53 FfotKlaYo;oti5or:tto.eom Notary Public - State of $ `' Commission No. My Commission Expires: L LS Z c) (Rev. 08.12) + CITY OF SikiI40RD.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 #: 1� r 2.2—LAO ADDRESS: C_1)1__1C/> n�;C�a PL-1 � )OCCU "O Ate) t 1 d LP , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR ROOFING CONTRACTOR, ENGINEER, 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 "I HE 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: S CONTRACTOR SIGT�hCIURE:_ (MUST BE SIGNED BY LICENS OWNER/BUILDER) A FINAL ROOF INSPECTION IS REQUIRED: DATE: C L� 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 V Sworn to and Subs ibed before me this day oUt 20 � by: (,—Who is ❑` eP rsonally Known aor has ❑ Produced (type of identific n) as identification. Sig dfure otary Public SAMUEL MOOTY Stat 'Florida } MY COMMISSION a FF953572 v V " °�� '.?r • EXPIRES January 25. 2020 W(;/1'.11i-!i•t: FbfN1t1N0;a'Y�CtYK.C.::OT Print/Type/Stamp Name of Notary Public