2019 Hibiscus Rd; 18-3833; ROOFCITY OF
SkNFORD PERMIT APPLICATION
BUILDING DIVISION
Application No: 1 (j
Documented Construction Value: $
5
1,` Job Address: 20 ( 5 1,15 Historic District: Yes No[]
Parcel ID: 31- R _0E 6'7 J 6D0 0' d 6 H O ResidentiaL9 Commercial
Type of Work: New Additions Alteration Repair R Demo Change of Use Move
Description of Work: - (z 4) LA) t k k- 0 j GL L+ ';;- k ih q ] V-.S
Plan Review Contact Person: t... Ic 1a-, Title: re .S
Phone: -t l`) o- Z Fax: l}7 _?&_) -_2/ 1,:2 Email: L \4l f o0 Ng • C-dv-'
1 /
Property Owner Information
Name J e^n /V e 0 W C21A Phone: f 09 -•
n,fStreet: 2D19 1' \t 0 b Sn_,t_ Spp Vt' Resident of property?: e,.5
City, State Zip: <5a:tL , I "I 3 Z
Contractor Information ,
e
Name LA U,' 1W I Phone: `L 7` Z -
Street: 0 Fax: A
City, State Zip: N M IMA Sig l - State License No.: C 0 3 2' -5 J-4,
Architect/Engineer In77forlation Name: /,) )+
Phone: Street:
City,
St, Zip: Bonding
Company: h- Address:
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: 6`h Edition (2017) Florida Building Code
NOTICE: In addition to the requirements of this permit, there maybe 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
done in compliance with all applicable laws regulating construction and
Signature of Owner/Agent Date
lV
O vn /A ut's Name
gnatur (of;Notary=Siate'ofFloiidat0iifiAlNE GAE'ADate
i :i, Notary Public - State of Florida
My COMM. Expires Jan 25, 2019 )
Commission # FF 165086
Owner/Agenf s -PersohaU Known-to=ML
e
or Produced
ID Type of ID and
that all work will be b
WIS Print
C rac r/ geut's Nauu a
d 911611 I.
GRRAINE IiAE?A 3.
Notary Public - State of Florida Cr.
mra. Expires Jan 25, 2019 Contractor%
Agent is C:
mr ission Personally
Kfio vn to Me or Produced
ID Tvwe ofTD` BELOW
IS FOR OFFICE USE ONLY Permits
Required: Building Electrical Mechanical Plumbing Gas Roof Construction
Type: Occupancy Use: Total
Sq Ft of Bldg: Min. Occupancy Load: Flood
Zone: of
Stories: New
Construction: Electric - # of Amps Plumbing - # of Fixtures Fire
Sprinkler Permit: Yes No # of Heads APPROVALS:
ZONING: ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Fire
Alarm Permit: Yes No WASTE
WATER: BUILDING:
SCPA Parcel View: 31-19-31-511-0000-0640 Page 1 of 2
c Property Record Card
Parcel: 31-19-31-511-0000-0640
sc+cxtmtxJrrttncroA Property Address: 2019 HIBISCUS CT SANFORD, FL 32771
Parcel Information
Parcel 31-19-31-511-0000-0640
Owner(s) EWMAN, LINDA
Property Address 2019 HIBISCUS CT SANFORD, FL 32771
Mailing 2019 HIBISCUS CT SANFORD, FL 32771-4522
Subdivision Name ROSE COURT
Tax District S1-SANFORD
DOR Use Code 01-SINGLE FAMILY
Exemptions 00-HOMESTEAD(2002)
IM&Wj
o
I.
Legal Description
LOT 64
ROSE COURT
P63PG4
Taxes
Sales
Land
Save Our Homes Savings: $342.50
TRIM Notice Help
Does NOT INCLUDE Non Ad Valorem Assessments
Method Frontage Depth Units Units Price and Value
FRONT FOOT & DEPTH 75.00 140.00 0 300.00 22,275
Building Information
Is Bed/Bath count incorrect? Click Here.
Description
Year Built
Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Adj Value Repl Value AppendagesActual/Effective
1 SINGLE 1945/1960 6 3 2_0 1,363 2,594 1,995 SIDING $102,191 $166,842
FAMILY GRADE
3
I
Permits
Description Area
BASE 632.00
DETACHED
GARAGE 575.00
UNFINISHED
OPEN PORCH
24.00
FINISHED
Permit # Description Agency Amount CO Date Permit Date
01574 INGROUND SWIMMING POOL SANFORD 37,000 5/20/2008
03834
INSTALL 25' WOOD FENCE ALONG BACK OF PROPERTY - 85' PVC FENCE ON LEFT SIDE W/4' &
3' ALUMINUM GATES
SANFORD 7,023 8/16/2005
00551 INSTALL 30' X 6' TALL PVC & 30' X 3' PVC W/LATTICE SANFORD 1,000 11/25/2003
01433 1 ADDITION ALTERATION SANFORD 1 $37,000 4/1/1998
Permit data does not orlglnate from the Sem Inole County Property A ppra l sees office. For data Its or questions concern Ing a perm It, please contact the bu IIding department of the tax dl strict In which the property Is located.
http://parceldetail.scpafl.org/ParcelDetailInfo.aspx?PID=31193151100000640 9/7/2018
1WE
I1:,,,
ROOFING
JTI Roofi
Address: 406 Hermitage Drive Insurance Co.
Altamonte Springs, FL 32701 Adjuster:
Phone/Email: (407) 767-6912/lg@jtiroofing.com Claim #:
State -Certified Roofing Contractor - CCC1325756 Phone:
State -Certified General Contractor — CGC036067
Jan Tukker, Contractor
Customer Name: Un d a l V P....u' n -I a n Date:
S060
Address: 2-01 I 4- 1 b t S Cu S (4City/State/ZIP: 'S Q n fo lid Z 7 —? l Home
Phone: L+()_ -7S J L(— 1 S' Cell: Work Phone: Email:
L 1h rJ o Ph yj S 1 ao (, C D M Project
Address: ITEM
TYPE QTY AMOUNT TOTAL Tear -
off shingle Replace
shingle Replace
underlayment Hurricane
Retrofit Steep
2nd
Story Charge Valley
Material Drip
Edge Vents
1" Vents
2" . Vents
it Goosenecks
4" Goosenecks
10" Flat
Roof Interior/
Exterior Skylights
Solar
Panels ITEM
TYPE QTY AMOUNT TOTAL dge
Vent f ff--
Ridge Vents Decking
Lead
Boots Debris
Removal Wood
N
Roll
Yard with Magnetic Roller ._.- tke.-S ` 5/t> t 5 Protect
Landscaping Where Applicable / Delivery/
Sp MAW
Shingles -
Manufacture: jj A. F Style: olor: `
Typ ' - ; Z (`Z A Warranty
Labor S Roof
l vt c s Insurance
Co. Initia]/
Estimated Amount
Date:
Insurance
Co. Agreed Amount
Date:
Upgrades
Insurance
Supplement of L
Da PAYMENT
SCHEDULE ` ( ` N 50%
DOWN PAYMENT PRIOR TO ORDERING MATERIALS PAYMENT
IN FULL UPON COMPLETION EARNESTDEPOSIT:
0$500.00 $1000.00 $ P—
DOWNPAYMENT $ FINAL PAYMENT $ JAN
TUKKER, PRESIDENT TERMS:
THIS AGREEMENT IS "SUBJECT TO" INSURANCE COMPANY APPROVAL. JTI ROOFING IS AUTHORIZED
TO PERFORM WORK AND RECEIVE FULL AMOUNT OF INSURANCE PROCEEDS, INCLUDING OVERHEAD
AND PROFIT, ONLY UPON APPROVAL BY INSURANCE COMPANY. ACCEPTANCE
OF AGREEMENT The
above prices, specifications and conditions of this agreement are satisfactory and are hereby accepted. I/We have read and understand the terms and conditions locatedonthebackofthisdocument/agreement. JTI Roofing is authorized to do the work as specified and in accordance with the terms, conditions and stipulations ofthisagreement. Homeowner hereby authorizes Insurance Company and/or Mortgage Company to make payment for completed repairs directly to Contractor and mailinsuranceproceedstoContractor. Homeowner hereby assigns to Contractor their rights to any insurance proceeds from Insurance Company for goods and services
as described in the specifications. THREE
DAY RIGHT OF. RESCISSION THIS
WRITTEN AG E T HEREBY SERVES AS NOTICE THAT I MAY CANCEL THIS AGREEMENT AT ANY TIME
PRIOR TO MID T OF T1J,E THIRD BUSINESS DAY AFTER THE DAT, O THIS AGREE NT. Homeowner
Approval: D
Contractor
Approval: Date: 1,
K
Grant Maloy, Clerk Of The Circuit Court & Comptroller Seminole County, FL
Inst #2018102828 Book:9206 Page:905; (1 PAGES) RCD: 9/10/2018 3:07:24 PM
REC FEE $10.00CL
THIS INSTRUMENT Pf2EPAR D BY rlllivp
r
tJi '
Name:
Address: Ey
A'`k1f,Adu 4. t2i <li!j .120 Date
C[ERK
NOTICE OF COMMENCEMENT
Permit Number:
Parcel ID Number. I -3 Qnlb — L5q u 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 dgscription of the properAi and street address if -available) 2.
GENERAL DESCRIPTION OF IMPROVEMENT: 3.
OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMP Name
and address: 1 Li P 20j 9 /,L'I ; Interest in
property: &e, Fee Simple
Title Holder of other than owner ilsted above) Name: 4. CONTRACTOR:
Name. "lL- C, ii __-- -Ph-
e Number: a — -71, 2— (o / Z. Address: to /
Zm i i4-21P .! tFYI'17`t wy yl F—C S %t.QiiK/J /— / Z% d S. 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. 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. State of
04A, County of lffP 411 Ajl 0 I ` The foregoing
instrument was acknowledged before me this day of 7. v _Yc—Y .20 t8 by INJ4.
Lz W Who is personally known tome OR Plame of
person making statement » ' who has
produced identification type of Identification produced: t— F i,m..
rl r blic -Sidle of Florida v • t --
My Ccmm. Expires Jan 25, 2014I 1 CI
oFFo;.•' Commission # FF 165681
Product Approval Specification Form
Permit #
Project Location Address MR ' \n S 4,ttS QA As
required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the information
and product approval number(s) on the building components listed below if they are to be utilized
on the construction project for which you are applying for a building permit. We recommend that you
contact your local product supplier should you not know the product approval number for any of the applicable
listed products. Be aware that windows, skylights, and exterior doors must be tested in accordance
with the Florida Building Code, Section 1714.5. More information about Statewide Product Approval
can be obtained at www.floridabuilding.org. The
following information must be available on the jobsite for inspections: 1.
This entire product approval form 2.
A copy of the manufacturer's installation details and requirements for each product. Category /
Subcategory Manufacturer Product Description
Florida
Approval # include
decimal) 1.
Exterior Doors Swinging
Sliding
Sectional
Roll
Up Automatic
Other
2.
Windows Single
Hung Horizontal
Slider Casement
Double
Hun Fixed
Awning
Pass
Through Projected
Mullions
Wind
Breaker Dual
Action Other
June
2014
Category / Subcategory Manufacturer Product
Description
Florida Approval #
including decimal)
3. Panel Walls
Siding
Soffits
Storefronts
Curtain Walls
Wall Louver
Glass block
Membrane
Greenhouse
E.P.S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles
Underla ments 0 A) t4
Roofing Fasteners I
Nonstructural
Metal Roofing
Wood Shakes and
Shingles
Roofing tiles
Roofing
Insulation
Waterproofing
Built up roofing
System
Modified Bitumen
Single Ply Roof
Systems
Roofing slate
Cements/
Adhesives /
Coating
Liquid Applied
Roofing Systems
Roof Tile
adhesive
Spray Applied
Polyurethane
Roofing
E.P.S. Roof
Panels
Roof Vents F b Z IZ-I I
Other Dj J a 0 - %L-
June 2014
Category/ Subcategory Manufacturer Product
Description
Florida Approval #
include decimal)
5. Shutters
Accordion
Bahama
Colonial
Roll up
Equipment
Other
6. Skylights
Skylights
Other
7. Structural
Components
Wood Connectors /
Anchors
Truss Plates
Engineered Lumber
Railing
Coolers/Freezers
Concrete Admixtures
Precast Lintels
Insulation Forms
Plastics
Deck / Roof
Wall
Prefab Sheds
Other
8. New Exterior
Envelope Products
Applicant's Signati
Applicant's Name
Please Print)
June 2014
CITY OF
ORD
FIRE DEPARTMENT
JOB ADDRESS:
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE ROOF SCOPE OF WORK
STRUCTURE TYPE: )g'SINGLE FAMILY RESIDENCE/TOWNHOUSE 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): "
PLEASE NOTE: ONLY 100 SQUARE FEET EXISTING DECK IS PERMITTED TO BE REPLACED -
ROOF VENTILATION: ,OFF -RIDGE E OSOFFIT OPOWERED VENT
l e YASO
SKYLIGHTS: OYES IO IF YES, PLEASE PROVII5E FLORIDA PRODUCT APPROVAL #: _
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 -4:12 4:12 OR GREATER
OTURBINES
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE T / ' FL#
O METAL FL#
0MODIFIED BITUMEN FL#
O TORCH DOWN FL#
O INSULATED FL#
O TILE FL#
O OTHER: FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IF APPLICABLE**
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 O 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
O INSULATED FL#
O TILE FL#
0 OTHER: FL#
CITY OF
x, Building &Fire Prevention DivisionSkNFORDRESIDENTL4LREROOFPOLICY & PROCED URES
FIRE D1rPARTM1 NT
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
SKYL"IGHTS-(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 WILI,,RESULITIY AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN
PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING DE COMPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNER/BUILDER) SIG / / DATE: v Z
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF AFFIDA VIT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
N ING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: /7-- 3 ADDRESS: 2.0
I
AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
OFING CONTRACT tNGINEER, ARCHITECT, OF F.S. CHAPT 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
P;REGOING 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 BAR IER AND NAILING OF THE ROOF DECK, IN ACCORDANCE WITH THE HURRICANE RETROFIT
MANUAL REQUIREMENTS (BASED ON F.S. CHAPI'ER,SiS ).
LICENSE #: 1 ' A & I
COMPANY / CONTRACTO6:
CONTRACTOR SIGNATURE:
MUST BE SIGNED BY LICENSE
2zjc
DATE:
THIS SIGNED AND NOTARIID FFIDAVI UST BE PROVIDED AT THE JOB SITE AT THE TIME OF THE FINAL ROOF INSPECTION,
ALONG WITH DIGITAL PHOTOGRAPHS QIF EACH PLANE OF THE ROOF SHOWING IN DETAIL ALL COMPONENTS (DECKING,
UNDERLAYMENT, FLASHING, DRIP ED E ATTACHMENT) WITH THE PERMIT NUMBER OR ADDRESS CLEARLY MARKED ON THE DECK
FOR EACH INSPECTION. THE PH( GRAPHS 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 ,zw "Ia`7
Sw rn to and Subscribed before me this day 20 q by:
AWho i Personally Known to me or has Produced (type of
as identification.
Signu4fre of Notary Public
State of Florida (SEAL)"--A-
I_arR,34tiF GiiETR
i Ho'8ry P;;blic - $ldto 01 FiOi;,a
Print/ ype/Stamp NameExpires
of Notary Public FF 165C66