Loading...
144 Wildwood Dr - BR17-002660 - ROOFCITY OF SANFORD s BUILDING &, FIRE PREVENTION PERMIT APPLICATION Application No: Documented Construction Value: $ Job Address: I `T 4 UV f (d Wood N , Qn ` rd fL Historic District: Yes No Parcel ID: 10' 20- 30-50z -0000- 01cf 0 Residentia1w Commercial Type of Work: New Addition Alteration Repair Demo Change of Use Move El,. ye t n'c p Description of Work: Ric-00'F Uie)q Rh+no ron-F iA-krv-;CQ,P UIa,Yrwn4 R 15a1 (T1?9, C'C_"'% sty -+ GAi~ t a+k'q PlanReview Contact Pjjeerso/n{: ' of bn e, Meehan Title: Prv)CCA MG P. Phone: 2) ( Olt " VS O Fax: Email- ,S MP,, Q N 1 Z , Wjwk Property Owner Information t Name 201U- 2- 60(rOWC1 LLC Phone: Street: nD( 06 EOMW Df 100 Resident of property? City,. State Zip: k0ftS d Cd KZ $ 5 Z 55 Contractor Information Name n-fi: Kwfi nq Street: n1 Fj0( u"P City, State Zip: Mal at R Z (j Name: 3- Street: City, St, Zip: Bonding Company: Address: Phone: 0 5) q- 19 Z 2 3.5 Fax: State License No.: CM - W S 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 apermit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understandthataseparatepermitmustbesecuredforelectricalwork, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, andairconditioners, etc. FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 5t1 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 befoundinthepublicrecordsofthiscounty, and there may be additional permits required from other governmental entities such as watermanagementdistricts, state agencies, or federal agencies. Acceptance ofpermit 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 ofpermit submittal. A copy of the executed contract is requiredinordertocalculateaplanreviewchargeandwillbeconsideredtheestimatedconstructionvalueofthejobatthetimeofsubmittal. The actual construction value will be figured based on the current 1CC Valuation Table in effect at the time the permit is issued, inaccordancewithlocalordinance. 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 theforegoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an zoning. Sign re of Owner/Agcnt Date Signature of Contractor/Agent ate Pnn ter/Agent's Name Print Contractor/Agent's Name Sid atureofN t D i tureofNo Sta fFi'orida ° j Date 00 Notary Pubic State of Florida 20<PA ic+ JESSICA ALEASE JennderCa-rasco * *MYCOMMfSSION#GGt178 3rwyCommissionGGtt4598 y of WIRES: March2,2021oF o Expires 06/13/2021 rFOF°F 4 80nd2d•Budgp(.fiotary SCtkes Owner/Agent is Personally Known to Me or Contractor/Agent is / Personally Known to Me orProducedIDTypeofIDProducedIDTypEe=ai"II5 BELOW IS FOR OFFICE USE ONLY Permits Required: Building Electrical Mechanical Plumbing[] Gas[:] Roof Construction Type: Occupancy Use: Flood Zone: Total Sq Ft of Bldg: Min. Occupancy Load: 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 WASTEWATER: BUILDING: Revised: June 30, 2015 Permit Application BENTLEY iL' Bentley- Roofing LLC 1777 Baj,iks Road Margate, FL 33063 Phone: 954.979.2233 Fax: 954.208.5900 CCC1328148 July 24, 2017 Submitted to: SMS C1404795 RE: 144 Wildwood Dr, Sanford, FL, 32773 We hereby submit the following scope of work for a residential re - roof - Shingles -`Remove 24 squares; replace with 27.6 squares of HD shingles (approved byHOA), Includes new boots, ridge caps, drip edge, removal and disposal of all relatedmaterials, and re -nailing plywood to code. Material: Shingles 30# Felt 1 '/ 'Nails Plywood 4" membrane Boxes tin tags Drip edge (10' per piece) Pipe boots Total job cost - $8,228 (includes first 3 sheets of plywood) Shingles - $7,728 (27.6 squares @ $280 per square) Permit/ Dump fee - $500 Any additional wood will be billed at - Plywood - $50 per sheet Fascia - $3.5 per lineal foot, plus cost of wood (all 1'x 2', 1' x 4........ to 1' x 1'0') Truss wood work- $ 2.0 per lineal foot plus cost of wood on all. Does not include A(c, skylights, solar panel, gutters- work unless mentioned in thescopeofwork 10 yr. labor warranty included Authorized Signer: Michael Devaney I r["ft.R RfS:t tnnit_.tii l!L'•:J'..!_ ersats'rra:lt:ut NOTICE OFC'ONINf ENC`EMENT IhctmSlTsrnld h tro)n gee s nauce thal iminixtrnuit ntlI he ina&- to certain real property: tmd inarcirdmi ce ltuh Ctlaptcr 71:, Florcis Statitivi. the rollo%mgmibrmation is ItroUded in the Notlrc of amnenecntent i DF.St'121IR1gS OF 1'ROl'EI+7 T 11e1Rl,,lN=1:21111 ot Cr_ p tiperly k!jwK.:w,hcxi if2:adap4t) T.4.\ FOLIO ?;Os SO.20-3D502.(i000-0790 SUBDIVISION PambleWood PB 23'POS 78i 8eLot.1. T1Ls(1 Lot 79 -eLDG I str 144 Wildwood DrSandiard, FL 32773 GF5ERAG DC'SFRIrtT10\ 011IMPROVEUFNT: O\\"NER2WOWNIMONORLERNE.F1liOR\i.1TICIND TH}. LEtiSL'ttY],V'IR\t'IED FUA ZUEI!t1y1pU F'UFay': d > nie aa. are CSN 2016-2 Borrower LLG 8665 E Hartford Dr #200 Scottsdale, AZ 85255 t,rri.r i ry.tim c :xrr andaddresx.0k<:..•yde mlr:,ti.Yrciyase i rla U.r..r 3vc.:.h.:ci caYix t luxs.44 L: Bentley Roofing e to k s>Ja> 1777 Banks Road. Wr9ate, FL 33063 :, a s a m,nt 954-979 2233 i sitttF'ft' Ofayi, :,ea51e a Tn• nCr!rlizlrru Sn>vnarra.hecr 3 \.i'JlinJaSdie P •trim•: cetlhri tFa:Siatc ri Ehxidar&Kruwtcd 1nt]luua ulxin \+lima: notices arc ollirr dmiumnlimay Fs z nrJ asixmided (u Sei'ttat?L3i;r1!(u17.1-ImOaSortgcs. .. `. . e:r:i:l'NO,Il'f•. aQ,i:1..;4th1 l':'J1C. . l: d,1n 11Rieltw Etimulf't limeli thtte: desip1c.., Ot' to 5L Y:ll' actgn t't'.he 41ena's?.ulice i pran'iw d in Section 733.13 (I) (h), Fkn da Stautli-s 1, Ph.,re:—,imhcr.,:7arm .cear., d .p^:y dM U„oc. _ . ... _.._......._. ., .. r t^ p;rrnttn dd aet'nnttx ofconlmtxic\mlent (thc e\Pitabon daa:.ltl1 it I •.cdr thorn the dalc ofrtte d:ni unless atilt) tent JAc is Sil;aa c orrhlnrrar t.es5cc, or<)Nnrr*v or I.e:3ce's (Print'Name and Provide Signatory's Titki'OfFFce) Authorized Otlrcer.. t)irrctonl*srtncrfktamgerj it:ltc 'i- ,/ Cotattv Ile (twill msourrici-t a-, LTbnlnll:d=d tvlMo mc-1WY da" 01_ nzz u istnt) thr, of nut m- ttum.. a ot.mei. uu,(att.une (to Wet)' in:ntic ofpalU lnt tl` :31101 :111URt )1'SiilGnent t\di P.,m-uteJ) ltrxn.tl F:mrq[`VtvPindocoaldMtllfKatien 1YpeOT)tl[tEtfie^.tiaiFrcxtitr; r r'f •"•, ,RA.IETLOPEZ (tir'riaturc of star' Pub is MYCOMMISSIONtf OM30 ohoa Type.ntitanep('aw mc!utaicdNamoal'Vmunpuhhc) p 3 EXPIRES: Febttlary 18, 2016 t h' ButdCdThNt WYFohit..SJ90cMa12rs GRANT MALOY, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL CLERK' S # 201708,3663BK 8973 Fig,Q980; (1pg) E-RECORDED 08//872017 09:44:31 AM 10: 00 LETTER OF AUTHORIZATION The individuals listed below are fully authorized to act on behalf of the following subsidiary entities: Adalwin, LLC; Beauly, LLC; Fetlar, LLC; SRP Sub, LLC; SRP TRS Sub, LLC; Starwood Waypoint TRS, LLC; Co1Fin AI -FL 2, LLC; ColFin AI -FL 3, LLC; ColFin AI -FL 4, LLC; ColFin AH-Florida 5, LLC; ColFin AH-Florida 6, LLC; ColFin AH-Florida 7, LLC; SWAY 2014-1 Borrower, LLC; CAH 2O14-1 Borrower, LLC; CAH 2O14-2 Borrower, LLC; CAH 2O15-1 Borrower, LLC; CSH 2O16-1 Borrower, LLC and CSH 2O16-2 Borrower, LLC together the "Entities") to apply for, negotiate, settle or appeal and execute all necessary documents with any municipality in connection with all matters related to, building permits, code violations, special assessments, liens, fines, or property taxes for properties owned by any of the Entities until this Letter of Authorization is changed or withdrawn by written notification to such municipalities. Randy Gray Regional Manager 954) 256-9100 John Rapisarda Regional Manager 813) 666-8455 Allen Waters Field Operations Manager 813) 892-9547 David Leger Service Operations Manager 813) 321-3103 Tia Gonzalez Service Operations Manager 813) 414-5443 Michael Fuster Service Operations Manager 9S4) 547-245S Michael Scott Service Operations Manager 954) 534-6881 Jazz Mitchell Service Operations Manager 727) 385-5264 Julie Hynds Property Compliance Coordinator 954) 256-9101 James Vance Compliance Manager 480) 800-3401 Leo Lluberes Service Operations Manager 813) 321-3103 Rebeca Venzal Property Manager 954) 399-6794 Giselle Roig Property Manager 954) 519-5205 Sultana Higgs Property Manager 954) 399-6749 Address for Correspondence: Colony Starwood Homes 8665 East Hartford Drive, Suite 200 Scottsdale, AZ 85255 5fi-its Ryan B r Date EVP, General Counsel Colony Storwood Homes - 9305 E Via de Ventura, Suile 201 • Scottsdale, AZ 85258 • T: 480.800.330r3 Notary Public - Arizona Maricopa CountySTATEOF ) My Commission Expires ss On this [7- day of ,« (-7 before mepersonally appeared Ryan 8eny, to nneknown tobethe person described inand who exexutd the foregoing instrument, and acknowledged that he/she executed the same as their free act and deed. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal the day and year last above written. My commission expires: Printed Name: Colony Stonwuo6Homes ~ 9305evia d: Ventura, Suite 20l - Scottsdale, ^Z852J8 ' T: 480.8003300 CITY O SkNFORD Building & Fire Prevention Division FIRE DEPARTMENT Re -Roof Permit Card PERMIT NO. / 7` Cz (0 too ISSUE DATE: C) /07 CONTRACTOR:fky aoi6n! JOB ADDRESS: Iq q [A) TYPE OF WORK:Iqe, J&O -r 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 5:00 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 111 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 ofnails) 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 F D City of Sanford Building Division Residential Re, -Roof Inspection Policy & Procedures PERMITTING REQUIREMENTS - NoPLAN 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 theSanford Historic Preservation Board INSPECTION POLICY & PROCEDURES' A Final RoofInspectionis 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 theroof, 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 nailsSkylights ( 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: PERMIT # City of Sanford Building Division Residential Re -Root Scope of Work JOB ADDRESS: 1,44 Wildwood Dr STRUCTURE TYPE: 0 SINGLE FAMILY RESIDENCUTOWNHOUSE 0 MOBILE HOME 0 APARTMENT/CONDOMINIUM RE -ROOT' TYPE: (0 REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS) 0 RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF) DECK TYPE, (PLEASE SPECIFY): - . C'OCA PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK is PERmjrTED TO BE REPLACED" ROOF VENTILATION: OOFF-RIDGE 0 RIDGE O-SOFFIT- OPOWERED VENT OTURBINES' SKYLIGHTS: 0 YES 0NO IF YES, PLEASE PROVIDEFLORIDA PPO]wm- APPROVAL r -------------------- MAIN ROOF AREA, ROOF SLOPE: 0 LESS THAN 2:12 02:12-34:12 4:1 2'OR GREATER TYPE OF ROOF MANUFACTURtR FLORIDA PRODUCT APPROVAL S SHINGLE GAF FL# FL101'24-R1, q METAL FL# 0 MODIFIED, BITUMEN FL# O TORCH DOWN FL# OINSULATED FL# OJILE FL# OOTHER: underlayment Interwrap Rhino roof & Garlise FL,# FU 5216-R2- FL16785-R6 Vv V1 I vall%-'yz ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **1FAPPLicABLE** ROOF SLOPE: 0, 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 FLA 0M0DIFIFD BITUMEN FL# 0 TORCH DOWN FL# OINSULATED FL# OTILE FL# 00THER-. FL# 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 Page 2 Application Number . . . . . 17-00002660 Date 9/05/17 Property Address . . . . . . 144 WILDWOOD DR Parcel Number . . . . . . . . 10.20.30.502-0000-0790 Application description . . . ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . . . . SINGLE FAMILY Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 1001437 Permit pin number 1001437 Required Inspections Phone Insp Seq Insp# Code Description Initials Date 1000 111 BL03 FINAL ROOF _/_/_ CITY OF OR DBuilding & Fire Prevention Divisionis1! RESIDENTIAL RE -ROOF AFFIDAVIT FIRE DEPARTMENT RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT #: ' 2 C, D ADDRESS: I Ll 1-1 W \ \ ( V.) O 0 6, I) r c,,,. \ o r _ F L_ 3 2--7 _ 3 I O\ ' Gkg` cx-y i c.q , 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 #: L C C-' 3 2 & ) L) COMPANY / CONTRACTOR:e aA-2 ay CONTRACTOR SIGNATURE: DATE: MUST BE SIGNED BY LICENSE HOLDER OR OWNER/BUILDER) 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. Z r0 W O-- I STATEOFFLORIDACOUNTYOFSworn to and Subscribed before me this day of O a . 20 by: YYyl C'V- a_A Ot-V GlY1 `- Who is ersonally Known tome or has Produced (type of identification) as identification. 0111N 111111// 41 fSi atureoNotaryPublicof Florida z s- '' Ira, t- Print/ Type/Stamp Name 0285, T y •• m eg ' o of Notary Public i i/ 9,QA/ L CISAo\\\` Iloil111I O