HomeMy WebLinkAbout113 Oak View PlCITY OF ORD
SkNFBuilding & Fire Prevention Division
PERMITAPPLICATION
Application No12-IM
Documented Construction Value: $ 9,612.00
Job Address: 113 Oak View Pl. Sanford, FL 32773 Historic District: Xes❑NoR
Parcel ID. 10-20-30-511-0000-0070 Residential Commercial❑
Type of Work: New[]Addition❑ Alteration[] Repair Demo ❑ Change of Use❑ Move ❑
Description of Work: Re -Roof CertainTeed Landmark Architectural Shingles 28sq.
Plan Review Contact Person: Saundra Bracken Title: Office Manager
Phone: 407-878-3750 Fax: 407-960-2612 Email: BrianSikesRoofing@cfl.rr.com
Property Owner Information
Name Anton, Carter Phone: 941 518-7862
Street: 113 Oak View PI. Sanford, FL 32773 Resident ofproperty?,: Owner
City, State Zip: Sanford FL 32773
Contractor Information
Name Brian Sikes Phone: 407-878-3750
Street: 1550 S HWY 1792 Fax: 407-960-2612
City, State Zip: Longwood, FL 32750 State. License No.: CCC1325977
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company: Mortgage Lender:
Address: 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: 6`" 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 1CC 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.
Signature ofOvmer Agent Date
V'—
;' n�4fi Notary Public State of Florida
Steven Campbell
+p, c My Commission FF 990959
,1%0 Expires05110/2020
Owner/Agent,is Personally Known to Me or
Produced lD ./Y, Type of IDi� L
Signature of Contractor/Agent Date
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Print Contr Agent's Name
igna �UN.t.ryf Florida Date
WA,gen
ary Public State of Florida
ven Campbell
Commission FF 990959
res 05/10/2020
Contra n 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:
Flood Zone:
# of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads
APPROVALS: ZONING: UTILITIES:
ENGINEERING:
COMMENTS:
FIRE:
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
THIS WSTRUMENT PREPARED BY:
Name: Saundra Bracken
Address: 1550 S Hwy 17 92
Longwood, FI 32750
NOTICE OF COMMENCEMENT
Permit Number.,.
Parcel ID Number: 10-20-30-511-0000-0070
11111111 Hill 11111111111111111111 fill 1111
,_t,�.r„ i � i`ii;ii_.t:� ', .:;i:.l :Ch t7L,_ (::[fi.li•,
CLEFM IS It 21.11.80413MW
J.ii;'••,'i,)ii5 .i.i�';_)i{:•.i.d il('i
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.
1. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
113 OAK VIEW PL SANFORD, FL 32773 - LOT 7
PB 54 PGS 93 THRU 95
GENERAL DESCRIPTION OF IMPROVEMENT:
Re -Roof CertainTeed Landmark Architectural Shingles 28sq.
OWNER INFORMATION.OR LESSEE INFORMATION IF THE LESSEE CONTRACTEDFOR THE IMPROVEMENT:
Name and address: CARTER ANTON - 113 W OAK VIEW PL SANFORD FL 32773
Interest in property: Owner
Fee Simple Title Holder (if other than owner listed above)
/ 1r—D 4. CONTRACTOR: Name: Brian Sikes Phone Number: 407-878-3750
\�f Address: 1550 S Hwy 17 92 Longwood, FI 32750
5. SURETY (If applicable, a copy of the payment bond is attached): Name:
Address: Amount of Bond:
6., LENDER: Name: Phone Number:
Address:
7. 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)(a)7., Florida Statutes.
Name: Phone Number:
8. In addition, Owner designates
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number:
9. Expiration Date of Notice of Commencement (The expiration 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.
1-2 Tin � 1 k- e
(Signature o ner or Lessee, ar ees or Lessee's (Pnnl Name and Provide Signatory's Title/ofrice)
Authorized Officer/Director/Partner/Manager)
State of FL County of 5iJ r�1 / 11d .( r
The foregoing Instrument was acknowledged before me this
by Av roli l2 61=ice
Name of person making statement
who has produced identlficatlo0Jtrpe of identification produced:
Rw W PU-
+r
'd �!
W *
Notruy Pubpc S" of Florida
Steven Campbell
My Commiabn FF 990959
Expires 05111012020
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 PRESERVATIONBOARD
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.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE:
1550 S. Hwy 17 92 Ph: (407) 960-2611
Longwood, FL 32750 Fax: (407) 960-2612
Anton Carter
113 Oak View Pl.
Sanford, FL 32773
(941) 518-7862
Contractor submits this proposal for work on the property herein described.
Upon acceptance, Contractor agrees to furnish labor and materials necessary
to improve the above premises in a good, workmanlike and substantial
manner according to the terms, specifications, prices and plans (if any).
Start and Completion: The approximate start date of i/ 26 f t '� and
approximate completion date of 1Z V 11'Y are subject to permissible
delays as per provision (5) on the reverse side. %
Submitted by X %' � 31)-1 �
Approved and Accepted (Contractor) Date
Remove existing shingle roof and underlayment to expose decking.
28
60.00
1,680.00
All damaged plywood decking if any will be determined at completion of tear off and will be replaced at a rate
of $60.00 per 4x8 sheet. (Price includes labor and materials.)
Additional damaged wood if any will he determined at completion of tear off and will be replaced at a rate of
$55.00 per hour and the cost of materials.
Install 2 Win. 8D Rink Shank coil nails along all trusses every six inches to properly secure decking.
28
10.00
280.00
Install one layer of Synthetic underlayment.over entire 5/12 pitch roof.
28
45.00
1,260.00
Install 2 1/2in: galvanized eave-drip around entire perimeter of roof. (Eave drip will have a baked enamel
250.00
250.00
finish) 04,4-e
Install peal n seal and valley metal in all valleys.
I
100.00
100.00
Install two ]Oft. aluminum ridge vents. Vents will be fastened using 1 1/2in. neoprene screws. fsht k
2
20.00
40.00
Install three 4in. exhaust vents.
3
20.00
60.00
Install one 1 1/2in,.lead boot.
1
15.00
15.00
Install two 2in. lead boots.
2
15.00
30.00
Install one 3in. lead boot.
1
20.00
20.00
Properly fasten and seal flashing along all walls, eaves; valleys, vents, and boots.
Install limited lifetime CertainTeed Swiftstart starter shingles with a wind resistance of up to 130 MPH.
0.66
175.00
115.50
Install limited lifetime CertainTeed. Landmark. architectural shingles with a wind resistance of up to 130 MPH.
26
210.00
5,460.00
Shingles installed -with six nails per. shingle. C-r ., r /
Install limited lifetime CertainTeed
Shadowridge hip and ridge shingles with a wind resistance of up to 130
1.34
225.00
301.50
MPH.
Ground will be swept with a magnet at the end of each working day.
Clean entire work area and haul away all debris.
7 YEAR LEAK WARRANTY (LABOR AND MATERIALS)
Price includes labor, materials, taxes and all permitting fees.
Contractor shall provide all releases of lien from contractor, subcontractors, and material suppliers.
TOTAL $9,612.00
ACCEPTANCE OF PROPOSAL
This Proposal is approved and accepted. There are no oral agreements. The written terms, ,,v�
specifications, provisions, prices and plans (if any) are the entire agreement. Changes will be X �l ,y 3 made by written change order only. Credit cards may be subject to a 3% convenience charge Approved and Accepted(Owner) Date
You, the Buyer, may cancel this transaction at any time prior to midnight of the third business day after the date
of this transaction. See Owner's Right to Cancel on the reverse side for details.
2/28/2018
SCPA Parcel View: 10-20-30-511-0000-0070
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Parcel Information
Property_Record Card
Parcel: 10-20-30-511-0000-0070
Property Address: 113 OAK VIEW PL SANFORD, FL 32773
Parcel 10-20-30-511-0000-0070
Owner CARTER ANTON
Property Address 113 OAK VIEW PL SANFORD FL 32773
Mailing 113 W OAK VIEW PL SANFORD, FL 32773
i— — - - - - -- — -._.._
Subdivision Name TERLINGWOODS
Tax District S1-SANFORD
DOR Use Code , 01 SINGLE FAMILY
--Exemptions I 00 HOMESTEAD(2011)
+ ti1 48.22 ° 50 50 50
5i -
$ r.r
NMI
00
N
Q'=
N- O CD
73.22 50 50 50
Seminole County GIs
Value Summary
2018 Working
2017 Certified
Values
Values
f —
~�Cost/Market
I Valuation Method
Cost/Market j
Number of Buildings
1
1
j Depreciated Bldg Value
$114,755
$108,242
Depreciated EXFT Value
$288
$300
Land Value (Market)
$25,000
$25,000
Land Value Ag
jJLi yMarket Value "*
$140,043
$133,542
Portability Adj
j Save Our Homes Adj
$44,852
$40,309
Amendment 1 Adj
$0
y
P&G Adj
$0
$0
Assessed Value
$95,191
$93,233
Tax Amount without SOH: $1,755.00
L 17Jbx F iII Amount $987.45
Tax Estimator
Save Our Homes Savings: $767.55
' Does NOT INCLUDE Non
Ad Valorem Assessments
Legal Description
i.
LOT 7
STERLING WOODS
PB 54 PGS 93 THRU 95
- -- _ —
..............
Taxes
_ _.-......_... _.
t-
Taxing Authority
(Assessment Value
Exempt Values I Taxable Value
County----
General Fund
i
L�- _.._ .... __
_ --- . —e
$95,191
_...-------.
$50,000
—�—�
$45,191 I
Schools
$95,191
$25,000
$70,191
City Sanford
$95,191
$50,000
$45,191
SJWM(SaintJohns Water Management)
$95,191
$50,000
$45,191
County Bonds
$95,191
$50,000
$45,191 i
Sales
Description
Date 1 Book i Page
Amount
I {
I Qualified Vac/Imp
WARRANTY DEED
8/1/2010 07441 0119
$126,000 Yes Improved
{ CERTIFICATE OF TITLE
6/1/2010 07395 0424
$103,000 No Improved
SPECIAL WARRANTY DEED
4/1/2001 ,40 067 0777
$105,200 . Yes Improved
WARRANTY DEED
11/1/2000 03956 1690
$327.000 No Vacant
�
{ �Ittd i rattlFaefats3p Sti�:as ;
Land
i Method I Frontage
Depth Units
I Units Price
Land Value
LOT
--�
1
$25 000 00
$25,000
Building Information
Is BedBath count incorrect? Click H re.
—T_— — - '-----
# Description Year Built Fixtures
..-.....- _ __
( Bed Bath i Base Area Total SF ! Living SF
; Ext Wall
_
Adj Value € Rapt Value Appendages
http://parceldetail.scpafl.org/ParcelDetailinfo.aspx?PID=l0203051100000070
1/2
2/28/2018
{, i Actual/Effective
G E 2001
{ FAMILY
SCPA Parcel View: 10-20-30-511-0000-0070
7 3 2.0 1,424 1,840 1,424 CB/STUCCO $114,755 $121,434 I Description Area
FINISH _
GARAGE —1 400.00
FINISHED
OPEN i
PORCH 16.00 i
FINISHED
Permits
Permit # 1 Description
1 Agency
Amount
_._
CO Date Permd Date
01297 C/O HVAC NO DUCTWORK.MECHANICAL.
SANFORD
$4,714
4/30/2013
00741 NEW - RESIDENTIAL
SANFORD
$66,000
5/1/2001
01591 16 X 20 WOOD DECK
SANFORD
$1,200
5/1/2001
Extra Features
Description Year Built
I Units
Value
-- '
New Cost
-—._.__....
PATIO 1 10/1 /2001
w
_�
1
_�__.. _ --- --
$288,
$500
http://parceldetaiI.scpafl.org/Parcel DetailInfo.aspx?PiD=10203051100000070
2/2
I PERMIT It
City, of Sanford Rnilding Division
Residential Re -Roof Scope of Wbit
JoB ADDRESS: 113 Oak View P1. Sanford, FL 32773
STRUCTURE TYPE: SINGLE FAMILY RESIDENCE/TOWNHOUSE 0 MOBILE HOME 0 APARTMENT/CONDOMINIUM
RE -ROOF TYPE: (Z) REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
0,RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): PIYWOOd
"PLEASENOTE. oNLY100spUAREFEETOF THE EXISTING DECKIS PEAU177ED rOB-PREPLACED**
ROOF VENTILATION: OOFF-RIDGE & RIDGE OSOFFIT OPOWERED VENT oTuRBINES
SKYLIGHTS: 0 YES (2) NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
------ — ------------ - — -------- ------------ ---- — ---- — -- — ---------- — ----- — - — ---- — -- -- — --- — — ------- ----------- — . ..... — ------
MAIN ROOF AREA
ROOF SLOPE- 0 LESS THAN 2:12 02:12-4:12
S) 4:12 OR GREATER
TYPE: OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
(X),SH1NdLt
CertainTeed Landmark
FL# FL5444-R,12
OMETAL
FL#
O MODIFIED BITUMEN
OTORCHDOwN
FL-9
OINSULATED
FL#
OTILE
FL#_
-0OTHER:
FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) "IFAPPLICABLE"
Rbor. SLOPE-. 0 LESS THAN 2:12 02:12-4- 112 0 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
ftowbA PRODUCT APPROVAL
OSHINGLE
FL#
OMETAL
0 MODIFIED BITUMEN
OTORCH DOWN
FL#
OINSULATED
FL#
OTILE
FL#
OOTHER:
FL#
City ,of Sanford
a21#1diii and Fire Prevention
2ESiDENTIAL RE-Ro')F INSPEt-4,16N AFFIDAVIT � {
NAILING, SHEATHING, DRY -IN, FLASHING, ANWIX�Lt FINAL ROOF COVERINGS
PERMIT #: 18-2199 ADDRESS: 113 Oak Viev. p'
Sanford, FL 32773
I Brian Sikes - i
� : AS A(N) GENERAL, BUILDING, RESIDET4k�.NL, OR
RoOFRJG CON ItAC'I' )k ENoom R,,ARCHITECT, OF F 3, CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
FOREGOING INFORMATION' 1S. 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 - SPECIFICArIY FLORIDA BUILDING CODE, EXISTING BUILDING. IN ADDITION I CERTIFY THE iNSTAI;CATION 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#: CCC1325977
COMPANY/ -CONTRACTOR: Brian Sikes Roofing
CONTRACTOR SIGNATURE:
(MUST BE SIGNED BY LICENSE HOLDER O ERJILDER)
DATE: 5110/18
A FIDA-L RO.)F INSPECTION IS REQUIRED:
THIS SIGNED AND NOTARIZED AFFIDAVIT MUST BE ,,, CWi1DED AT THE JOB SITE AT THE TIME OF THE FINAL ROOF INSPECTION,
ALONG WITH DIGITAL PHOTOGRAPHS OF EACH L �F THE ROOF SHOWING IN DETAIL ALL COMPONENTS (DECKING,
UFNDERLAYMENT, FLASHING, -DRIP EDGE ATTACHME WITH THE PERMIT NUMBER OR ADDRESS CLEARLY MARKED ON THE DECK
FOR EACH INSPECTION. THE PHOTOGRAPHS MMX.J 'ODE A RULER OR MEASURING DEVICE TO CONFIRM ALL NAIL SPACING AND
OVERLAPS, INCLUDING DRIP EDGE AND VALLEY Fl.:f zip G. PLEASE REFER TO THE RE -ROOF POLICY AND INSPECTION PROCEDURE
-'PAPERWORK FOR FURTHER EXPLANATION OF ALL RE64REMENTS.
**FAILURE TO FOLLOW ALL REQUIREMENTS 'r'ILL RESULTINN FAILED INSPECTION, A RE-INSPECTIQN FEE AS
WELL AS REQUIRING A DESIGN PROFESSION/ ARCH ITECT OR ENGINEER) TO CERTIFY, BASED ON PERSONAL
INSPECTION, THE INSTALLATION OINVA, I G C OMPONENTS.
STATE OF FLORIDA COUNTY OF j=.mmo:2
Sworn to and Subscribed before me this 1.0 day of May 20 18 by:
Brian Sikes Who is R Personally Known to me or has ❑ Produced (type of
identifies ' ) _ as identification.
ure of o Public -
State of Florida ;:,'fir " k°tlsryry°.Politic Sizde'°} fl°'itla- -
.., Steven Campbep
Steven Campb ;ll ""yC0R1"W1012 �; W
o„ evfts..olHla�o2o.
Print/Type/Stamp Name "
of Notary Public