313 McKay Blvd 17-1322; ROOFCITY OF SANFORD
W-)
BUILDING & FIRE PREVENTION
l l PERMIT APPLICATION
Application No: / - / 3 2-- '
Documented Construction Value: S - I t I U L
Job Address: 1 (,i1 u Historic District: Yes No W
Parcel ID: - ? `- (c)- i)st(-) Residential Commercial
Type of Work: New Addition Alteration Repair [9 Demo Change of Use MoVe
Description of Work: rt YC S C) In/f T) ( OVn I rl 0 Ft 1 () ( 01 L.1
Plan Review Contact Persot`V11Ij({'TO 1 K A1yV1J- _ Title:
Phone: _q07 Z7f- -7 f Fax: 3 -31y
Property Owner Information
Named U Phone:
Street: CA Resident of property?
City, State Zip:
Contractor Information
Name Y ' Phone.
Street: Fax: ;L"I
City. State Zip: State License No.:
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 CONINIENCENIENT 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.
F BC 1053 Shall be inscribed with the date of application and the code in effect as of that date: 5ih Edition (2014) Florida Building Code
k,:,,rd Jun: 1p.2015 Pe,mil Annhedition .. -
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c UT[CL: In addition to the tcqutrentcnts of this pernut, there may be additional restrictions applicable to this property that may be
found In the public rocords ot'thts 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 Sanlbrd 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 it 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 %vill 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 `Hill
be done in compliance with all applicable laws regulating construction and coning.
Signature of 0%%wr,Agent Date Signature of Contractor/Agrnt Date
V -k \ K1 t
Print owner/Agent's Nanue Print ontractor/Agent's Name
Signature of tlotary-State of Florida Date
e.
W"'
IMAR B AMKRAUr
FF 127
M, C01mmfasiwn EaOires
June 01. 2018
Owner/Agent is Personalty &&own to tote or
Produced ID Type of ID
Signature Date
Contractor/Agent is Personally Known to Me or
Produced ID _Q Type of ID 6 ' -
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gus[] 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 Meads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
k_.:_:,; Iunc30,_o15
UTILITIES:
FIRE:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Pcrmit ,kpplicauon
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Jasper Contractors, Inc.
5380 E. Colonial Dr.
Orhuldo, FL 32807
407) 278-7798
337-3361 Fax JASPERJasperRoof.Com
info@Jasperinc.com Je p rRoof.eom
Contractor's License N CCC1329651
MM VISA '
ROOF REPLACEMENT CONTF
Address:
1 ( 3 C a 1(
City: C^ State; I Zip
Account Mana er%
Contact # V1 2_
Insurance Compamv Information
Company re 1'1n
Policy # 7
Claim #
Morteaee Comnanv Information
Company (/i'f ttU
Loan Number 7
CT
Phone: 907 310 3 !2 '
Alt Phone:
Shingle Color,f _/ • e .,
Email: 1 'Q s y/. V "" "r °' Roof RCV amount: Drip Edge C toR14krntir. /Yl l. 1,o $9,100 %N/
If Owners Insurance gompany does not agree to pay for a full roof replacement this contract shall be null and void.
Assignment of Insurance Benefits for the Full Roof Replacement Only: I hereby assign any and all insurance rights, benefits and proceeds
under any applicable insurance policies to Jasper Contractors, Inc. ("Jasper"), the scope of which shall be limited to a Full Roof Replacement. I
make this assignment and authorization in consideration of Jasper's agreement to perform services, supply materials and otherwise perform its
obligations under this contract, including not requiring full payment at the time of service. I also. hereby direct my insurer(s) to release any and
all information requested by Jasper, its representative, or its attorney for the direct purpose of obtaining actual benefits to be paid by my
insurer(s) for.services rendered: In this regard, 1 waive my privacy rights. If payment is made directly to the Owner/Agent/Insured(s), it shall be
endorsed over to Jasper immediately upon receipt. I agree that any portion of work, deductibles, betterment or additional work requested by the
undersigned, not covered by insurance; must be paid by the undersigned on the day of installation.
Deductible; It is the Owner's responsibili!y to pay all Insurance Deductibles. Owner's out-of-pocket expense will not exceed the deductible
amount, as stated on insurer's loss sheet, UNLESS replacement/repair of deteriorated decking is required and/or Owner requests optional
upgrades. Jasper CANNOT pay, waive, rebate, or promise to pay, waive or rebate all, or any part of the insurance deductible applicable
to the insurance, claim for payment of work. In the event of a discrepancy, the deductible amount stated on ;the insurer's Loss 'Sheet, shall,
overrule Deductible I st t ve.
Deductible: $ Vt v MUST BE PAID IN FULL, PLUS,APPLICABLE SALES TAX 95 (initial)
MORTGAGE A ORIZATION: I, Owner/Mongagor, grant authorization for Mortgage Co[j speak with
Jasper on matters including, but not limited to, the claim and draw status. '(initial)
PAYMENT SCHEDULE: Owner agrees to pay Jasper based on the following pay scheduler (i) Deposit in the amount of S_ due
upon signing this contract; (i) the Contract Price, less the Deposit and any applicable depreciation retained by Owner's insurer(s), plus
Upgrade Costs, due and payable to Jasper upon completion of work being performed; and, (iii) the remaining Contract Price (equal to any
applicable depreciation and/or change orders) due and payable to Jasper upon completion of work performed. In the event of a pending
inspection, no more than 2% of Contrac Price may be withheld until inspection has passed. 1 ryOptional: UPGRADE ITEM: r QTY PRICE: TOTAL: S
Replacement Work and Price: Upon insurer's approval and subject to the terms and conditions herein, Jasper agrees to furnish all. materials
and provide the labor necessary to perform the full roof replacement which shall take place following Owner's insurance -company's approval;
approximately within 30 days, conditions permitting:
Owner's Declaration of Intent: Owner acknowledges, and agrees that, upon approval.by insurance company for full roof replacement, Jasper
shall perform the roof replacement upon receipt of funds from Owner's insurance company.
CANCELLATION: If Owner elects to terminate the services of Jasper, Owner may do so before midnight on the third business day
after Contract is executed. Owner shall receive a full refund of all deposits. Owner may also rescind Contract before midnight on the
third business day after the contract is executed after notification from insurer(s) that the claim for paymenton roof contract has been
denied, in whole or in part. All written notices of cancellation, regardless of reason, shall be postmarked or delivered to Jasper's
corporate office; 1690 Roberts Blvd Suit 112 Kennesaw, GA 30144. CANCELLATION EXCEPTIONS: The three (3) day right of
r
s
cancellation DOES NOT APPLY to contracts for emergency home repairs as time is of the essence.
btL; Owner, have read and understand all statements, terms and conditions of the "Roof Replacement Contract" and agree that all
G
a details are acceptable and satisfactory. I further understand that this contract constitutes the entire agreement between the parties and
that any further changes or alterations to this contract must be made in writing and agreed upon by both parties. Each party_
represents and warrants to the other that it has the full power and autho to enter Into the contract and that it is binding and
enforceable in accordancewith its terms.
ItS'ANp ITIONS: Acceptance of Terms: i, Owner, hereby agree to
ions stared herein. I further agree to provide Jasper with the Scope of Lose R
to the property for the purpose of staging and wntpletingAll agreed trplw vvo
Date
spa foe a full roof repleicemeat on the terms and
crated 6y aijr +irtiid nulhariae and grant fbll
the right to file a
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THIS INSTRUMENTPREPARED 13Y•
Name: Jasper Contractors
Address: onway _Road idle 201
Ll "; I Zs
NOTfCE of COMMENCEMENT
GRANT NALOYr SEI1If1OLE COUNTY
CLERK OF CIRCUIT 'COURT & COPIPTROLLER
BY 8906 Ps 390 (1f'9s)
CLERK'S A 2011043979
RECORDED 05/04/2017 01..24.4.6 P11
RECORDING FEES t6l. .00
RECORDED BY jeck,:::nvo
lermit Number:
arcel ID Number: -J k 19 - -Sal
he undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the
iflowfng Information is provided in this Notice of Commencement.
Legal description of the properly and street address ff available)
M
GENERAL
OWNER 11
Name and
Interest in
Fee Simple Title Holder (if other than owner listed above) Name:
Address:
CONTRACTOR: Name: Jasper Contractors Phone Number. 407-278 7788
Address: 3203 S Conway Road Suite 201 Orlando, FL 32812
SURETY (If applicable, a copy of the payment bond is attached):
Amount of Bond:
LENDER: Name: Phone
Address:
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)(2)7, Florida Statutes.
Phone Number:
address:
n addition, Owner designates of
o receive a copy of the Lienor's Notice as provided in Section 713.13(i)(b), Florida Statutes. Phone number:
xp)ration Date of Notice of Commencement (The expiration is 1 year from dale of recording unless a different date is specified)
ING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE
SIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR
NG TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH, YOUR LENDER OR AN ATTORNEY
RE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
S(gnaturcorcm r co, orOvmc arLesscos Frio amoandFrovida5 natory'sTiUe/0(fice)
Authaftcdo[Mc rl0rreclor/Partner anagcr) y,.
sr % ' 0--
v
County of cl'IJVVV YJ`
ice20regoinginstrumentwasacknowledgedbeforeme {his day of
Who is personally known to me OR 7- o
Ngmc o/person aking statement \\
s produced identification type of identification produced: V `!
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a
F-
v 0. .
SKYLAR B AMKRAUT 0 H 0
yP 4B i ommission N FF 1278211
W
0 0
ires LA' My Commission Exp Notarysignaturc
Z
June 01 , 2O1 B j Cr LUWJ Z Uj
vu<Ln m
t. OF ATTOEY
Altamonte Springs, Casselber"ry, Lake Mary, Long1vood, Sanford,
Seminole Counity, Winter Springs
Date:
I hereby name and appoint: Skylar Amkraut, Karla Almodovar, Rachel Holcomb, and Ana Chavez
an agent of Jasper Contractors
Name orCompany)
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:
A
Expiration Date for This'Limited Power of Attorney: 1/1/2018
LicensdHolderName: MichaelStaphen
State T icense NUMber: CCC1329651
Signature of Incense Holder: • „
STATE OF FLORIDA
COUNTYOF
The foregoing instrument was acknowledged before me this r day of I1 1 C1 lf 20017 , by Michael Stephen who is. personally knowntomeorwwho .has produced .DL as
identification and who did" (did not) take an oath..
Notary Seal)
SKYLAR B AMKRAUTt a
Commission q Ff 127890
a' My Commission Expires
June 01, 2018
Rcv. 08.12)
Signature
Print or type name
Notary Public- State of
Commission No. 1
My Commission ,E• cpires:
City of Sanford
Building & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO./ 7 -a 1%3 A ISSUE DATE: 195o 0 gs 1 7
0*
CONTRACTOR: Vaz 4Av- a
JOB ADDRESS: ,3 "ft\ak 8/(;O w
TYPE OF WORK: r"M P
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
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 3:30 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
PERMIT #
M City of.Sanfol d,Building Division
r Residential Re -Roof Scope of Work
JOB ADDRESS: \ .. t t , i „'1 0 (A
STRUCTURE TYPE: 0 SINGLE FAMILY RESIDENCU- TOWNIIOUSC 0 MOBILE HOME, 0 APARTMENT/CONDOMINIUM
RE -ROOF TYPE: Q-REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INS"I-Al.t.l3D OVER 13aISTING ROOF)
DECK TYPE (PLEASE SPECIFY):
PLEASE NOTE: OA'LY 100 SQUARE FEET OF THE EAISTIAW DECK IS PERAHTTED TO RE REPLACED "
ROOF VENTILATION: /O1T-RIDGE RIDGE SOFFIT OPOWERED VENT
SKYLIGHTS: O YES 0 NO 1F YES, PLEASE: PROVIDE FLORIDA PRODUCT APPROVAI. #
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 02:12 -4:12 '(V4:12 OR GREATER
OTURBINES
TYPE OF ROOF MANUI
ACTURERj
FLORIDA{\P((R
yODuC'
T APPROVAL
IJw (0v t ' A FL#
Q.METAL
1
FL#
0 MODIFIED BITUMEN FL##
OTORCH DOWN FL#
OINSULATED FL#
OTILE FL#
O OTHER: FL#
ROOF EXTF,NSIONS.(PORCFIES, PATIOS, ETC.) **/FAPPLICABLE**
ROOF SLOPE: 0 LESS THAN 2:12 0 2:12 -4:12 O 4:12 OR GRI-ATI.R
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
0 SHINGLE FL#
Q MLTAL FL#
0MODIFIED BITI141EN FL#
QTORCH DOt3FN FL#
0 INSULATCD FL#
OTILE FL#
0 0-mER: FL#
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 -wiII not be issued without these documents. Copies will be made to Poston 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 InsnectionJs 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 Correspolnding 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 F C code compliance by personal inspection.
CONTRACTOR (OR OWNER/BUILDER) SIGNATIJRI;: ` ,, DATE:
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: -- L ADDRESS: e7)\ T'-ii \j
I 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 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 #: Vm `x J 1
COMPANY / CONTRACT
CONTRACTOR SIGNAT
MUST BE SIGNED BY L
OR:IJIC U `r •J
URE: ! DATE: 'E
10ENSE D WNE
A FINAL ROOF INSPECTION IS REQUIRED:
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 1 _)— day of 20 _aby:
Who is Personally Known to me or has Produced (type of
as identification.
Sign atur t Notary Public
State of I 1 rida
S Amkmt
Print/Type/Stamp Name
of Notary Public
I a°a;,' SKYLAR B AMKRAUT. IE
Commission N FF 127890
MY Commission Expires
4
June 011 20T8 ' F