HomeMy WebLinkAbout2102 Cordova Dr 17-1287; ROOFCITY OF SANFORD
MAY - k 2017 BUILDING & FIRE PREVENTION
PERMIT APPLICATION
D
Application No:
Documented Construction Value: $ -31 b -
Job Address: Va Coal n / ?(, Historic District: Yes No
ParcelID: p ` J D - 53u -' ( rt Residential Commercial Type
of Work: New Addition Alteration Repair Demo Chang e of Use Move Description
of Work: CrDpr- /q So, O f-rh.l 4PC WiA S i'/,1 l %o ?OA Plan
Review Contact Person: L isA- Title: Phone:
qc)0 33& o3LI6 Fax: Ull0 3Za Email: l`i111 iQ JYrJ , W .(&Lj Property
Owner Information Name
R e)Qfd7) Cruz Phone:Lj0l) 3 a.L/ (a6_5 Street:
112 rRa ` m Tif rynof ) Resident of property? : Iy ID City,
State Zip: UC L/ 10 Contractor
Information 2
Name '
h n , l o nC_ Phone: q 3 3 F Street:
rr
Fax:
City,
State Zip: r 0 3 State License No.: WA
Architect/
Engineer Information Name:
Street:
City,
St, Zip: — Bonding
Company: Address: ---
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: 51 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 71.3.
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.
Sie of Owner/Agent Date
Pri t OwnerPriOwner/Agent E—
L 21I 01
Signature of Notary -State of Florida Date
eL
Signs re ontractor/Agent Date
obl\
Print Contractor/Agent's Name
of Notary -State of Florida Date
ANNIE MART! NZ
mComission # FF 142513
gtQ My Commission kxpires
I July 1 6, 201 8
Owner/Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me or
Produced ID _1, Type of ID FL -Do vT c L'c eri Produced ID Type of ID F 1, Dl--
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
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
of Heads
UTILITIES:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
d _,s75_
Revised: June 30, 2015 Permit Application
v
FLORIDA SHORT -FORM INDIVIDUAL ACKNOWLEDGMENT
F.S. 695.25
State of Florida
County of hoLC)a
4-i f`Ya , Place
Notary Seal Stamp Above The
foregoing instrument was acknowledged before
me this I-9- day
Date
of (
y I , Q.'(
2 Month
Year by
N bd o Gu-?, , Name of
Person Acknowledging who is
personallyknownn ,to
me
or who has produced
E101_''O 2,f ke nS-.
Type of
Identification as identificatio
Signature of
Notary Public T, Ptd
ho n) Nam f
No ary Typed, Printed or Stamped Notary Public —
State of Florida OPTIONAL Though
this
section is optional, completing this information can deter alteration of the document or fraudulent
reattachment of this form to an unintended document. Description of
Attached Document tb Title
orTypeofDocument: ,or' ('J r•' Document Date:
Number of Pages: 114 Signer(s)
Other Than Named Above:
SCPA Parcel View: 36-19-30-534-0500-006A Page 1 of 2
Property Record Card
Parcel: 36-19-30-534-0500-006A
ti Owner: CRUZ ABELARDO & DE LA TORRE TAVIANA
Property Address: 2102 CORDOVA DR SANFORD, FL 32771
Parcel Information Value Summary
Parcel
Owner
36-19-30-534-0500-006A
CRUZ ABELARDO & DE LA TORRE TAVIANA
Property Address 2102 CORDOVA DR SANFORD, FL 32771
Mailing 118 RANDON TERR LAKE MARY, FL 32746-
Subdivision Name HIGHLAND PARK
Tax District S1-SANFORD
DOR Use Code 01-SINGLE FAMILY
j Exemptions
j
c
i
minole Cou ty GIS
Valuation Method
Number of Buildings _
Depreciated Bldg Vale
Depreciated EXFT Va
Land Value (Market).
Land Value Ag
Just/Market Value
Portability Adj
Save Our Homes Adj.
Amendment 1 Adj
P&G Adj _ ^-
AssessedValue Tax
Amou 2016
Save
Our F TR
Does
NOT INCLUDE Legal
Description SLY
15 FT OF LOT 6 +ALL LOT
7 +LOT 8 (LESS SLY 43 FT)
BLK 5 HIGHLAND
PARK PB4PG28
Taxes
Taxing
Authority Assessment Value I
Exempt
Value County
Bonds 50,058 t City
Sanford 50,058 SJWM(
Saint Johns Water Management) 50,058 Schools
60,778 I
County General Fund 50,058 http://
parceldetaiLscpafl.org/ParcelDetailInfo.aspx?PID=3619305340500006A 4/18/2017
Proud Member Phone: 407-332-0345
A Fully Licensed State Certified Fax: 407-332-0243
Roofing Company o . johnkeller5@cfl.rr.com
Lic.#CC-0058308
ggg www.johnkellerroofing.com
CLIENT
bi
PH. # DATE
ADDRESS =.
ld
DAYTIME # FAX #
PROPERTYADDRESS V/
RE EXISTING ROOF/INSPECT FOR WOOD ROT V INSTALL NEW ARCHITECTURAL/3 B-SIiI ES ROVE
ENAILDECKING PER CODE INSTALL
NEW UNDERLAYMENT SYNTHETIC
UNDERLAYMENT DOUBLE
LAYER OF UNDERLAYMENT FOR LOW SLOPE
NAIL
BASE PLY BASE ANS
ALL NEW PIPE FLASHINGS & EXHAUST VENTS PIPE
FLASHINGS & EXHAUST VENTS TO BE PAINTED FLASHINGS
AND VENTS SUPPLIED BY OTHERS z/
1NSTALL NEW ANGLE FLASHING WHERE EAVE MEETS ROOF
DECK. (BEHIND FASCIA BOARD/ALUMINUM) D SHINGLECOLOR: V
INSTALL NEW EAVE METAL: SIZE: 1; COLOR: INSTALL
NEW METAL PANEL ROOF 4
L t- L'M / %% INSTALLNEWi' . _ ULTRA RIB PANEL ICE &
WATER SHIELD SHIE D-VALLEYS ARE CLOSED V - CRIMP CUT
STANDING
SEAM INSTALL
DIVERTER/CRICKETT BEHIND CHIMNEY INSTALL
GRANULATED MODIFIED INSTALL
NEW FLASHING/ V AND COUNTER FLASHING BITUMEN LOW SLOPE SYSTEM SEAL
W/ POLYURETHANE G/'! v COLD
PROCESS MOP DOWN INSTALL( )
NEW SKYLIGHTS) SIZE: _ SBS SELF ADHERING GLASS
TOP ONLY _ PLASTIC DOME ONLY ODIFIED COLOR FLUSH
MOUNTED PLASTIC DOME FACTORY
SEALED CURB & PLASTIC DOME _ ROTTEN WOOD REPLACED AT A SEPARATE FACTORYSEALED
CURB& GLASS TOP (DOUBLE PANE) RATE OF $5.50 PER LINEAL FT. OF BOARD REUSE
EXISTING SKYLIGHTS/NO WARRANTY AND/OR $60.00 PER SHEET OF PLYWOOD. INSS
ALL NEW ATTIC VENTILATION SYSTEM A HIGHER RATE WILL APPLY FOR CEDAR V
INSTALL ( ) OFF -RIDGE ATTIC VENT(S) OARDS AND NON-STANDARD PLYWOOD. INSTALL( )
TURBINE VENTS FOR LOW SLOPE PROPERTYOWNER(S)ARERESPONSIBLEFOR INSTALL
SHINGLE OVER ATTIC RIDGE VENTS ON REMOVAL
OF SOLAR PANELS, SATELLITE ENTIRE
RIDGE ( ) FT./50YR-1IOMPH TESTED INSTALL
METAL ATTIC RIDGE VENTS ( ) FT. DISHES, AND GUTTERING. ALL
REROOFS INCLUDE A TOTAL CL AN UP ANDMAGNETIC SWEEP ALL
LABOR WARRANTED AGAINST LEAKS FOR A PERIOD O . ,.!-" L/ 1
WE
PROPOSE TO FURNISH PERMITS, LABOR, AND MATERIALS IN ACCORDANCE WITH ABOVE SPECIFICATIONS FOR TH
AMOUNT OF DOLLARS ($S } }) 701DEPOSIT
REQUIRED. PAYMENT IS DUE IN FULL UPON COMPLETION. 40% DEPOSIT
FOR CUSTOM ORDER MATERIALS. BALANCE DUE IN FULL UPON COMPLETION. ACCESS TO
AND FROM STRUCTURE IS REQUIRED FOR MATERIAL DELIVERY AND DISPOSAL CONTRACTOR AND CONTRACTORS AGENT ARE NOT RESPONSIBLE FOR DAMAGE TO DRIVEWAYS,
SIDEWALKS, OR CEILINGS. OWNER ASSUMES ALL RESPONSIBILITY FOR HIDDEN CONDITIONS (WATER, ELECTRICAL, A/C LINES, ETC.) OR RELATED DAMAGES. OWNER MAY
OBTAIN INDEPENDENT ATTIC INSPECTION AND SUPPLY CONTRACTOR WITH A COPY OF FINDINGS. ALL LEFTOVER MATERIALS ARE PROPERTY OF JOHN KELLER ROOFING INC.
PROPERTY OWNER(S) TO CARRY FIRE, TORNADO, AND OTHER NECESSARY INSURANCE, SIGNED CONTRACTS NOT FULFILLED BY PROPERTY OWNER(S) ARE SUBJECT TO
A FEE EQUAL TO 10% OF CONTRACT VALUE. ALL INVOICES SUBJECT TO EXPENSES INCURRED IN COLLECTION TO INCLUDE, BUT NOT LIMITED TO ATTORNEYS FEES. PAYMENTS NOT
RENDERED IN ACCORDANCE WITH CONTRACT AGREEMENT ARE SUBJECT TO A FINANCE CHARGE OF 1.5 % PER MONTH. ACCEPTANCE OFPROPOSAL—
THEABOVEPRICE, SPECIFICATIONS AND CONDITIONSARE SATISFACTORYAND ARE HEREBYACCEPTED. YOU ARE
AUTHORIZED TODO THE WORK AND PAYMENT WILL BE MADE AS OUTLINED ABOVE. SIGNATURE
f 1101111" 1111 H11 1111H11 THIS
INSTRUMENT PREPARED BY: Name:
LISA KELLER Address:
2312 CLARK ST. B-13 APOPKA,
FL. 32703 NOTICE,
OF COMMENCEMENT r'
Permit
Number: I=.;
r;;II i'li'?' ;` ,E1'iT.i![)I._E: C`OL)i i...
l't.l t •..ry `_• . it. t_ i_, . ;_ fll_l l i L't ; _)I li' i 1 111_L_i.:. {t. 201.
704-21-7833 Parcel
ID Number: 36-19-30-534-0500-006A 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) SLY
15 FT OF LOT 6 + ALL LOT 7 + LOT 8 (LESS SLY 43 FT) BLK 5 HIGHLAND PARK PB 4 PG 28 F
TW- CIRCUIT COURT 2.
GENERAL DESCRIPTION OF IMPROVEMENT: AND COMPTROLLER 8`s REROOF
S'EiVtINOL' COUNTY, LO IDA 3.
OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: DEP Name
and address: ABELARDO CRUZ 118. RANDON TERRACE LAKE MARY FL. 32746 Interest
in property: OWNER y-9AY 2 Fee
Simple Title Holder (if other than owner listed above) Name: N/A Address: -------------
4.
CONTRACTOR: Name: JOHN KELLER ROOFING, INC Phone Number. 407-332-0345 Address:
2312 CLARK ST. B-13 APOPKA, FL. 32703 5.
SURETY (if applicable, a copy of the payment bond is attached): Name: N/A Address: ------------
Amount of Bond:------------ 6.
LENDER: Name: N/A 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:
N/A Phone Number: ------- Address: -------------
8.
In addition, Owner designates --------- of --------- 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. T'
ABELARDO CRUZ/OWNER Signature
of Owner or Lessee, or Owners or Lessee's Authorized
Offfioer/Diredor/Partner/Manager) Print
Name and Provide Signatory's Title/Office) IUI •
ICI u I/,n ,\ RU StateofCountyof ,1 1 l The
foregoing instrument wasacknowledged, before me this r day of j i I 20 Gr
GI > C+ by V Who is personally known to me OR Name
of n making statement persoonwho
has produced identification 2 type of identification produced: _ i'l lll p
JrC / 3)1 Q IAA 'b_\ ` i R 7" o4j3`
v TIFFANY HUGHof NotaryPublic - State of Florida Commission #
GG 058099 I
i
N;FOF1 d;A•'
My Comm. Expires May 4, 2020 I111111N Notary
Signature
CLERK 017
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:_J"
I hereby name and appoint: L i S f F-cA t e
an agent of:
Name of Company)
rg
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):
I The specific permAand application formwork
Street Address)
Expiration Date for This Limited Power of Attorney: } O( 31
License Holder Name: jrhn Kai )C!
State License Number:!Q 0 ns y-D12
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF SeMino k?
The foregoing instrument was acknowledged before me this 3'd day of M ,
20V 1-7, by SD k n ke I ler who is person own
to me or gwho has produced F L DLL as
identification and who did (did not) take an oath.
4AZUfl -
Signatur
Notary Seal) Anne M o r+f new
Print or type name
ANNIE MARTINEI Notary Public - State of f bridQCommission # FF 142513
or M y Commission Expires Commission No. f 144Z513
9:f0i July 16, 2018 My Commission Expires: 071((D(ZDI
Rev.08.12)
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 result in an affidavit provided by a Florida Design
Professional (architect or engineer), certifying FBC code compliance by personal inspection.
CONTRACTOR OR OWNERBUILDER SIGNATURE: DATE:
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS:` c 0—oYy'V mill l /V /
STRUCTURE TYPE: ® SINGLE FAMILY RESIDENCENOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: *REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): V 1 )O L
PLEASE NOTE. ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED
ROOF VENTILATION: ®OFF -RIDGE O RIDGE QSOFFIT QPOWERED VENT OTURBINES
SKYLIGHTS: O YES ® NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 — 4:12 ® 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE C FL# E5Yqq
O METAL FL#
p MODIFIED BITUMEN FL#
0TORCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
ROOF EXTENSIONS (PORCHES. PATIOS. ETC.) **IFAPPLICABLE**
ROOF SLOPE: p LESS THAN 2:12 Q 2:12-4:12 :12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
O SHINGLE FL#
O METAL FL#
p MODIFIED BITUMEN FL#
QToRCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
b
r >
s
D City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: ADDRESS: c) 19, C Orc- ppi1 Di t/
i n/,d C=( 3,=:_ - /
I ohn hej L e , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR ROOFI_
NG 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 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 #:
CC C t)5 V s bs COMPANY /
CONTRACTOR: CONTRACTOR
SIGNATURE: MUST
BE SIGNED BY LICEt 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 VJ ry l r10 I e) Sworn
to and Subscribed before me this 3 rd day
of M 20 17 by: SohYt
Ke I Ier . Who is Personally Known to me or has VProduced (type of identificaY )
i- L D L as identification. J
Signatur
of Notary Public """ ANNIE MARTINEZ p0.Y ?B(` State
of Florida =_ Commission V FF 142513 o
My Commission Expires Ahnle,
Mae r+I'''9FOfF0 0 July 16, 2018 Print/Type/
Stamp Name of Notary
Public