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413 S Myrtle Ave - BR185-004452 - REROOF RESIDENCE AND GARAGEI gyp( SXCITY OF NOV U 6.7 1 WNFORD, PERMIT APPLICATION BUILDING DIVISION Application No: Documented Construction Value: $ ram O'er Job Address: i + I ( Ave Historic District: Yes 14 No Parcel ID: _2_9-) q 30 " ft'1 -6lp 05-- 00 4 Residential 4 Commercial Type of Work: New Addition Alteration Repair Demo Change of Use Move Description ofWork: Plan Review Contact Person: 0 Ti Phone: Fax; Email: Property Owner Information Name \ml a \ l Gkyl Phone: Sly 3 Ct Street:' . :: Resident of property? k1rll4 W M(&Sv, City, State Zip:. ` r Contractor Information Name Kb k 4 D o\ V1 S Street:, City, State Zip: N \ VA\tV'— Name: Street: City, St, Zip: Phone: Lo aO Fax: - State License No.: CC(_ 13 2 & Te Architect/Engineer Information Phone: Fax: 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. 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: 61 Edition (2017) Florida Building Code NOTICE: In addition to the requirements ofthis permit, there may be additional restrictions applicable to this property that maybe 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 ofthe job at the time ofsubmittal. The actual construction value _ will befigured based on the current ICCValuation Table in effect at the time the permit is issued, in accordancewithlocal ordinance. Should calculated charges figured offthe 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 ofOwner/Agent Print Owner/Agent's Name Date Signature ofNotary -State ofFlorida Date Signature of o ctor/Agent Dad Ie'-. L4.,S Print Contracto Agent's N l M Vt" , it. (V.L0 MY coi 5j FF 956264 EXPIRES: March 23, 2020 BondedThru Notary Public Owner/ Agent is Personally Known to Me or Connractor/Agent is Personally Known to Me or Produced ID Type of IDProduced ID t/ Type of ID 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 FixturesFire Sprinkler Permit: Yes No # of HeadsAPPROVALS: ZONING: COMMENTS: UTILITIES: ENGINEERING: FIRE: Fire Alarm Permit: Yes No WASTE WATER: BUILDING: STRUCTURE TYPE: 0 SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM RE -ROOF TYPF,: 4 REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS) O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF) l ` /` DECK TYPE (PLEASE SPECIFY): Q l.... . "1 Cj UnA e(aA,1 jMfZ 7 1 - S I P /l.( Qtre, PLEASE NOTE: ONLY 100 SQUAR FEET OF THE EXISTING DECK IS PERMITTED TO BE R LACED** ROOF VENTILATION: ®OFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES SKYLIGHTS: OYES ®NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #: MAIN ROOF AREA ROOF SLOPE: O LESS THAN 2:12 ® 2:12 - 4:12 O 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL SHINGLE W eYl r n 1 n FL# iO O METAL FL# O MODIFIED BITUMEN FL# O TORCH DOWN FL# O INSULATED FL# O TILE FL# O OTHER: FL# ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IFAPPLICABLE** 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 SHINGLE FL# O METAL FL# OMODIFIED BITUMEN FL# O TORCH DOWN FL# 0INSULATED FL# O TILE FL# 0 OTHER: FL# CITY O S FORD Building & Fire Prevention Division RESIDENTIAL RE -ROOF POLICY & PROCEDURES FIRE DEPARTMENT I g -4q S' Z 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 OWNER/BUILDER) SIGNATURE: DATE: i CERTIFICATE OF APPROPRIATENESS - HISTORIC PRESERVATION BOARD CITY OF SANFORa 300 S. Park Avenue Sanford, Florida 32771 407.688.5145 • www.sanfor fI ovjHr- THIS DOCUMENT MUST BE POSTED AT ALL TIMES UNTIL PROJECT IS COMPLETED. ISSUED TO: DATE ISSUED: Linda Williams October 30, 20+2,-ZOMI 413 Myrtle Avenue Sanford, FL DATE EXPIRES: April 30, 204-r 2019 BP#19-105 Approved to reroof house and detached garage with Owens Corning Oakridge architectural shingles (in color "Estate grey") and underlayment as needed. Any wood replacement other than underlayment may require a separate Certificate of Appropriateness and possible site visit for approval. All pitched roof surfaces including porches and additions) must match in design, dimension, profile, texture, materials,,and other visual qualities. Eileen Hinson, Development Services Manager Please be advised it is the owner and/or agent's responsibility to notify staff of any potential changes from the approved COA that arise and obtain approval prior to commencing the changes. This Certificate of Appropriateness does not constitute final development approval. The applicant is responsible for obtaining all necessary permits and approvals from applicable departments before initiating development. IS A BUILDING P"IT REQUIRED FOR THE ACTIVITY LISTED ABOVE? CAS NO Building Department Representative tU TY OFa APPLICATION # FOR A CERTIFICATE OF APPROPRIATENESS Answer all the questions on this form and submit all required attachments. Incomplete applications will not be reviewed. If you have questions about application requirements contact the Historic Preservation Officer at 407.638.5145 to ensure your application is complete. General Information Downtown Commercial Historic District[] Residential Historic District Is this a retroactive request? Yes[:] No[:] Is this application filed in response to a Notice of Violation from the Code Enforcement Department? Yes[--] Noz Proposed improvements will affect the following elevations: North South East West Property Address: 413 S Myrtle Avenue Sanford, FL 32771 Property Owner Information Print Name: Linda and Darrell Williams Mailing Address: 413 S Myrtle Avenue Sanford, FL 32771 Phone:407.739.5980 Email: lindaw@sciFl.com BY SIGNING BELOW YOU ACKNOWLEDGE THAT A BUILDING PERMIT MAY BE REQUIRED FOR THE SCOPE OF WORK LISTED BELOW. YOU MUST CONTACT THE BUILDING DEPARTMENT TO DETERMINE IF A BUILDING PERMIT IS REQUIRED. FAILURE TO OBTAIN A BUILDING PERMIT WILL RESULT IN A STOP WORK ORDER, DOUBLE PERMIT FEES, AND POTENTIAL FINES. BY SIGNING BELOW, YOU ALSO ACKNOWLEDGE THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE AND ACCURATE TO THE BEST OF YOUR KNOWLEDGE. Signature: Date: Would you like to receive emailst regarding Historic Preservation and Community Planning within your community? Description of proposed work Completely describe the entire scope of work, including changes in material and color, and methods that will be used to accomplish the proposed work. For large projects an itemized list is required. Use the reverse side if necessary. HISTORIC PRESERVATION BOARD • 300 S. Park Avenue • Sanford, Florida 32771 •407.688.5145 • www.sanfordfl.gov/HP 413 S Myrtle Ave Sanford, FL September 28, 2018 Estimate # 10687 Scope- Home 1. Remove existing roof system to the sheathing. 2. Repair all rotten or otherwise structurai'damaged sheathing and lumber @ $1.80 per sq. ft. for sheathing and $4.00 per lineal ft for lumber. 64 sq. ft. of sheathing has been accounted for. 3. Install peel and stick self adhered undedayment for dry in . 4. Install new eave drip. Eave drip to be covered with Owens corning starter strip 5. Replace all attic vents, exhaust vents, and plumbing stacks. 6. Supply and Install 30 year Owens Corning architectural (Oakridge series) shingles. Color TBT). 7. Supreme series used for Ridge caps 8. Disposal, Permit and filing fees included. 9. Remove and install new seamless gutters. (white) 10. Manufactures standard product warranty. 11. Robert Binns Roofing 5-year workmanship warranty. houseMain •• • 0 11 a Garage it 11 a Total - $15,990.00 The above prices, specifications, and conditions along with the RBR, Inc. Terms and conditions are satisfactory and are hereby accepted. Robert Binns roofing, Inc is authorized to do the work as specified. Date; Signature:"J611'49W The purchase price shall include a non-refundable payment of 0% of the contract amount ($) representing the estimated administration fees and startup cost which are difficult to quantify. 3% Credit Card and or financing fee may apply. All final payments are due within 10 days of completion of the work. Checks made payable to Robert Binns Roofing Inc. Respectfully submitted Logan Albritton Robert Binns Roofing, Inc. Lic#ccc1325548 TERMS AND tCONDITIUN ' 2. Insurance. Contractor shall carry workers compensation, automobile liability, commercial general liability and any other Insure= required by law. 3. Access, Customar agrees to provide Contractor wihh adequate access toelectricity, and otherutilitiesasneeded, the work aile, and the work woo adjacent to the structural, Contractoris notliableandCustomerissolelyliableforthegrading, slope or construction of the roof deck, the roofing system or appurtenances, or work installed by any person other than Contractor, unless otherwise specified by Contractor kt tfris ggrosmenf. Customer agrees to provide of decksild*9 that are suf iclent to t amaterials as rewired. 4. Site Gat, . , . Ia. Should" DROW00 or Unkngwn t6ndbtfons to an'axtstktg atrttct4ra be at vathumwithocxttlt[iotu uxUc f In tho of dto woris to'ie Performed kern Urose dlnartly, ertci rnlerad and garitteffy recogniZ& as. Inherent ire wodc of the character pmwded fain ThisAgrsem&K Me Aweement price shall be equitably adjusted upon notice -tharW11MM theContractortotheCustomer.' 5. Pavment T¢rmn Rv.dnnliw #Me An-o i rti: . L.w is —, ar w votau ae ar ";,0F8w,to ere wnaEGrarm WMW00%'911trsequent to mpg thistrldtoW108setk* kr this txoposatrixii k8d ShO bs (increased WOW Owneed for a wrtUen tdtatiga order or amencirnent to'11 contract to reflect the price Increase and additional, direct cos! to tho CentrwAor. Contractor will submit written. documentation of the hkxeaseif Charges"to Ohe Cuslorrtot, The fame of CustWMAD maW proper payrrmrtt to Contractor when due shaft ert1gUe Conbador,,at its discretion, to suspend all `work, shunts andla wayffir s until W payment 4 Made or terminate this Contract. The ontract startShall beincreasedbytheamountofcontractorsreasonablecostsofshut -down delay and start-up. substrate foof gandit' results In pottybig pursuant to tho Fl rida ButkUng Cells anti ModiAcatfons w i tecptlred to correct the, roof so ponding will not occur. Coritractor wGt notifyCustomerkwrtsdtaally, itshall be the s*%,obfillatlon oftito Customerto dat rmtne the exiei of restrictions contained In deeds, subdivision or neighborhood regulations which might relate to or restrict the improvements under this Agreement Contraclor,staill Have no IlattUity or respmItillily for arty such nwo6hfitimifly with such rest/lcUCrtsfiegtdfartrents; Contractor shalt be Writled to paytltattt from Customer of ail sums dub hemimder nut Wistanft' anyk *tIon/piobbifon against the work as a result ofany vtotation ofsuch tasbttWequttement. 7. Customer Protection of Property. Due to the nature of the construction to be done at Customers request, the Customer takes sole responsibllity.for any, damage done to curbs, are ncement of roof repairs, remodeling, or other ch work. Unless otherwiseotheirivisespecified, there Is r will perform the work hereunder: within a cost for tesUng/abatement for asbestos Is the process. S. Choice of Law, Venue and Attorney's Fees. ThIsAgreernent shall be governed by the laws of the State of Florida Venue of any proceeding arising out of this Agreement shall be Polk County, Florida, unless t hopm#fea agree otherwise. Should ConkwAx employ;an attorney to Institute tit on or arbikagoisto enforce anyot tite p m*bns bw,* f, to pml eat itsinterestin any Me# oraltsiag,out 0000r retafad to this Agra n ti Contractor shall be entitled to recover hom'the Customer ail of1U attOrrtay'8 fs and cos knctuied Utareln. Including attorney 'a fees, andcostSIOPrMSincurflullatned#atlon, adtnlnistiaUve, appaiiade to bankrupk"yproh dings. g: Waiver of Jury Trial. THE PARTIES KNOWINGLY, VOLUNTARILY, IRREVOCABLY AND INTENTIONALLY WANE THE RIGHT TO A TRIAL BY JURY IN RESPECT TO ANY LITIGATION ARISING OUT OF OR PERTAINING TO THE AGREEMENT, OR ANY COURSE OF CONDUCT, COURSE OF DEALINGS, STATEMENTS ("ETHER VERBAL OR WRITTEN) OR ACTIONS OF ANY PERSON OR PARTY RELATED TO THIS AGREEMENT; THIS IRREVOCABLE WAIVER OF THE RIGHT TO A JURY TRIAL BEING A MATERIAL INDUCEMENT FOR THE PARTIES TO ENTER INTO THIS AGREEMENT. 10. 11, Warranties. Unless otherwise provided: THERE ARE NO EXPRESS OR IMPLIED WARRANTIES WHATSOEVER INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. All warranUes/ guarantess provided by Contractor, If any, shall be deemed null and void If Customerfails to strictly adhere to the payment terms contained in the Agreement. All warranfies and guarantees If any, provided under the Agreement are solely for the original Customer and are non-barhafllf", Unless otherwise agreed to by Customer and Contractor In writing. Any eipm warra<dy provided, if any, by Contractor is the sole and exdushW remoclif for alleged constroam defects. In lieu of all other remedies, implied or statutory. 12. Claims. tits Customer s dills jQrad[y kt wdNtthki 3 days of L+at'of any Winofdefkdon" t A4lvtces or'+na " a"µ} 'd tin under t7; xtaretx shall rasrdl jp UheCasttrrher waiving all f ms #hat may beM. tttmuC_-$7r r41 iitllllutdorrtttaino .the Ooctrr£tnCe fndt g d tit t ` tt' Lwttrass or ' tort txiedarai oriitiffilttlt 13. Arts of God. Cotttraciar shall nmt be gapte kx any damage, wheowl eDtaall ortonsequangaL or claim AN out of or reWing to Act of God, eccidarts diddislurt s d 8yb In oil nl ig rrstedaEs slays>GtlranOrtaU<rn, firesr webihef cortpons shies: warms olhercuatts beyondt aitrs + eortaWe contai, ttrckrding delays c by emir sot or Mod of Csustoirier, by any separate contractor employed by the Customer, or by changes ordered by the Customer in the work. Customer shall obtain prior to construction fire, tomedo, flood, builders risk and other necessary Insurance for this project 14. Drsclalmer. Contractor disclaims all liability for all claims, disputes, fights, losses, damages, causes of action or controversies ('Claims") pertaining to Mold, including Claims arising out or relating to the detection, removal, disposal, or remedlation of Mold, whetherthose Claims arise In law, equity, contract, warranty, tort, or federal or state statutoryclaims, and whether those Claims are based on the acts or omissions of Contractor or individuals or entities under Contractors control, The Customer Is solely liable and responsible for all damages, whether actual or consequential, caused by Mold andIncurred by Customer, Contractor or third parties. 15.; Working Hours. The proposal Is based upon Via performance of all work during Contractors regular working hours, excluding weekends and National holidays. Extra charges will be made for overtime and all work performed other than during Contractor's regular working hours If required byCustomer. 16. Materials. All materials and work shall be furnished In accordance with nomad industry tolerances for color, variation, thickness, size, weight, amount, finish, taidure and performance standards. Specified quantities are Intended to represent an average over (he entire roof area. Contractor Is not responsible for the actual verification of technical specifications of product manufacturers, i. e., R value, ASTM or UL compliance, but rather the materials used are represented as such by the manufacturer. Metal roofing and especially lengthy flat span sheet metal panels will often exhibit waviness, commonly referred to as toil -canning." 011-cannir0 pertains to aesthetics and not the performance of the panels and is not controlled by the Contractor. Contractor Is not responsible for oil -conning or aesthetics. 011-canning shall not be grounds to withheld payment or reject panels of the type specified. 17.. Construction and Interpretation. Each provision of the Agreement shall be construed as if both parties mutually drafted this Agreement If a provision of this Agreement (or the application of Ii) Is held by a court or arbitrator to be Invalid or unenforceable, that Drovision will be deemed Inst;F2UIbI2i4Ub bOOW: 12JU Page:1444; (1 HA(;t5) KUU: 1U/Lb/1UId 11:44:LU AM REC FEE $10.00 After Recording Return to: Robert$inns Rd2gM, Inc. *********** 6918 County Road 642 West Winter Haven, FL. 33880 Prepared By: Baley Davis******** Tax Folio # 25-19-30-SAG-0805.0080 State of Florida County of Seminole Notice of Commencement FS 713.13 THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statues, the following information is provided In the Notice of Commencement. 1. Legal description of property: LOTS 8 + 9 BLK 6 TR 5,TOWN OF SANFORD,PB 1 PG 58 2. General description of improvement: Re -Roof 3. Owner: Name and address Linda and / or Darrell Williams 413 Myrtle Ave Sanford FL 32771 a. Interest in property: Owner b. Name and address of fee simple titleholder (if other than Owner) N/A 4. Contractor: Name and address Robert Binns Roofing Inc. 5918 County Road 542 West Winter Haven FL 33880 a. Phone number 893-984-9685 Fox number (optional, if service by fax is acceptable) 883-084-96" 5. Surety: Name and address N/A Bond $ N/A a. Phone number N/A Fax number (optional, if service by fax is acceptable) 6. Lender: Name and address N/A a. Phone number N/A Fax number (optional, if service by fax is acceptable) Persons within the State of Florida designated by Owner upon notices or other documents may be served as provided by Section 713.13(1) (a) 7. 7., Florida Statutes: (name and address):N/A a. Phone number _ Fax number (optional, if service by fax is acceptable) 8. in addition to himself, Owner designates N/A To receive a copy of the Lienor's Notice as provided inSection713.13(1) (b), Florida Statutes. a. Phone number Fax number (optional, if service by fax is acceptable) 9. Expiration date of notice of commencement (the expiration date Is one (1) year from the date of recording unless different date is specified) 20 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 YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT, State of County of rnature of Owner The foregoln9 instrument was.acknowledged before me this _ day of , 20 [ , by LIn,6.Loc.W^ _ _ who is Personally Known To me or has produced as identification and who did (did not) take an oath. COWE E. JACKS MY COMMISSION 4 G04441$ EXPIRES`. November 02, 2020 AND --- Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read theforegoingandthatthefactsstatedinitaretruetothebestofmywledganbItf, . FORMS/N0C,rvnd2007 X sit a of atuni Penoo Signing (on line 010) A ova LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: I I hereby an agent 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): r. Expiration Date for T ited Power of Attorney: /y%i License Holder Na State License Number: ( cC_ Signature of License Holder: STATE OF O D COUNTY F The f ego' g ' nt w s owledged efore me this 4—da o.f , 20;_r, b who is personally known to me or who has produce as identification and whd not) take an oath. f Notary Seal) — /P_/'le - V yo_ Print or type name Notary Public - State o j4a'&__ Commission No. My Commission Expires: tP Pie,•,, JOERE:ELIZABETH GRAY Notary of Florida Rev. 08.12) P-N •{ Com03110 MY Comy31,2021