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HomeMy WebLinkAbout21-1334 ' e _ t# City of Zephyrhills PERMiIT NUMBER `- 5335 Eighth Street r Zephyrhills, FL 33542 BGR-001334-2021 Phone: (813)780-0020 Fax: (813)780-0021 Issue Date: 01/15/2021 Permit Type: Building General (Residential) Property Number Street Address 24 26 21 0110 00000 2880 3139 Nubbin Ridge Lane Owner Informmation Permit Information Contractor Information Name: NESTOR LANDRON JANELLE& Permit Type:Building General(Residential) Contractor: POST R US INC MOISES BERMUDEZ Class of Work:Fence Address: 3139 Nubbin Ridge Ln Total Valuation:$3,195.00 ZEPHYRHILLS,FL 33542 Total Fees:$55.00 Phone: (813)394-5676 Amount Paid:$55.00 Date Paid:1/15/2021 2:04:38PM Project Description INSTALLATION 184 FT X 6 FT PVC FENCE Application Fees Fence Installation Fee $55.00 REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c)the local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or first reinspection,whichever is greater,for each subsequent reinspection. 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 permit required from other governmental entities such as water management, state agencies or federal agencies. "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing,consult with your lender or an attorney before recording your notice of commencement." Complete Plans, Specifications add fee Must Accompany Application.All work shall be performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. CONTRACTOR SIGU4KRE PE IT OFFICE PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER ' I INVOICE , ' ' , I I FOR CITY OF ZEPHYRHILLS BILLING CONTACT CHRISTOPHER DAVIS I POST R US INC i 5150 HALSTEAD LN ZEPHYRHILLS, FL 33541 INVOICE NUMBER INVOICE DATE INVOICE DUE DATE INVOICE STATUS INVOICE DESCRIPTION INV-00002443 01/12/2021 01/12/2021 Due NONE I REFERENCE NUMBER FEE NAME TOTAL BGR-001334-2021 Fence Installation Fee $55.00 3139 Nubbin Ridge Lane Zephyrhills, FL 33540 SUB TOTAL $55.00 REMITTANCE INFORMATION TOTAL $55.00 City of Zephyrhills 5335 8th Street Zephyrhills, FL 33542 I January 12,2021 5335 8th Street,Zephyrhills,FL 33542 Page 1 of 1 I I INSTR#2021041 HS7 OR BK 10291 PG 1266 Page 1 of 1 03/02/2021 11:33 AM Rcpt:2267768 Rec: 10.00 IDS:0.00 IT:0.00 Nikki Alvarez-Sowles, Esq., Pasco County Clerk&Comptroller 11 �d cr lfE19G7��s61yi+�msaaLL+e�atb�cae�trib.emd�rtq.�.�, ..�. �.. > fe�l�glssbtmo6onr¢aAbdbOibl�e.dGomoep�R �tF-2b-c� oilp O=%dwd`PXPaft raxellIftowl••••, Q►1�:,�a _ e ��P72ir7��s-Ioa�c�t1_SS r3oeaelDasenm rjR i • 3 o.s.fa�fmari�vmtbta�eeot.®a�mta�offr®e � . A. am LU 335'�0 ramad�aeeoyo74t�e j �m�>mma.�es�amory j � � aorta rrh, l 335�2 oo�o�b�b•roa: mum s � i tab I Ae�dsost L T�°�� i Ul`�' � --- --- 7 paggm wm the atft d FWO did by Me d!!T mm Wm eftas Q Q& ►0e®0ft viv be owed as Rai"or •D MWE Td�doeMadtadO�OPape I �t`` •'ef��q� e{�� ti tpadmoebid�Bea�sd�..�. d—• ��' ® p �G bemdie.agfafb�k�eell�Ibm�praM�dbt�7tS1>i(t)�F;bf�E3LO�. � o �+�� Td 2O=W-- dpt�at$$Or �pYdm�dl�oararr�oQ,.eN+e ��,�ceamb.medo.�p�imdm „e+dasasmpatbe �• oodta bddlib ne 1� ombed..ateoaedtpmb.a�eedr�b ioatmr plaiBtrB wuE er tlECNi[�APT�71�a�ta►,aox CF7l�Norte OFao�1�1r AM T HBO 1 AA ae I� IBM E I mt CHIM 1OB81HG�TlER4iSf8 F Uuww•40 GONG1T ` y IF WON QiR41 O I N � .�q.l�ellD�t1E�®d��rgeffioedf��t bdr�0r�btoHrt� E 3: T aadbem V co a, v 1E U 3IAiE�iiA� I cc; + N qy j ai =WYCF r]I r/S 0(Jr p 0° ordafb or Admode�d a p v;cn Tv s I Bar ® •00 0 .0 O O I ,tee _l a,,5e 5 Uep I"t4 el a t. ° �°c o o 0 w 0 G/hw 11Ot++Ibbow V n a vi ($ i -C U U (6 a) 'i Q�ned d.p�Ca��dcr�AiOa�f;e��wae�.oamoelie�. �� � _ O O p ylpodroQQgpYddbedld o. � �1 i = a) •7 (9 () 7�odl aafioQim®d 3 1b0> tp 4�•�� K• ^f �y N p >' -0 Q)i U U O E W NC 0 cn >(D cu N a) Y U WILLIAM J KII4G _,'.,;Notary Public-State of Florida ' o- z o DO Commission#f GG 338261 My Commission Expires May 23, 2023 I , � I Acme Fence ACME FENCE A E CI�i 5844 1ST ST FE CE Zephyrhills, Florida 33542 "Your PVC Specialists" 813-779-7795 813-973-0826 888-779-8553 fax WWW.getfencenow.com acmefence@yahoo.com LICENSE # 11795 PROPOSAL/CONTRACT v 10/2P1/22e02 0 Customer Information: Job Information: MOISES & MONICA BERMUDEZ JOB LOCATED IN HIDDEN RIVER 3139 NUBBIN RIDGE LANE 813-394-5676 Zephyrhills, Florida 33540 MOEBERMUD3Z@ICLOUD.COM 813-394-5676 Notes: 1841 61 WHITE PVC TONGUE & GROOVE PRIVACY - COST OF THIS SIDE Se, 1 5 FOOT WALK GATE 1 1310.0 GATE POST W/ ALUMINUM I BEAM ExI TINe FENCE STAINLESS POWDER COATED HARDWARE t ALL POST SET 31 DEEP W/ 60#S CONCRETE 24' NIEVES HOUSE e. LIFETIME MANUFACTURE WARRANTY 1z 12, LIFETIME LABOR WARRANTY 12, PERMIT AND NOTICE OF COMMENCEMENT INCLUDED Ig PRICE INCLUDES SPLITTING SOUTH SIDE W/ NOC 8< PERMIT NEIGHBOR MANNY NIEVES ACME FENCE agrees to guarantee above fence to be job and adjustments for labor will be charged or free from defects in materials and workmanship for credited at the currently established rates. one year. Additional charges for any extra work not covered ACME FENCE shall advise the customer as to local in thislcontract that was requested by the customer zoning regulations but responsibility for complying will also be added. The full amount of this with said regulations and obtaining any required contract along with any additional charges will permits shall rest with the customer. ACME FENCE become payable upon completion of all work whether will assist the customer, upon request, in or not it has been invoiced. determining where the fence is to be erected, but A finance charge of 1 1/2% per month (or a under no circumstance does ACME FENCE assume any minimum of $1.00), which is an annual percentage responsibility concerning property lines or in any rate of 18%, shall be applied to accounts that are way guarantee their accuracy. If property pins not paid within 10 days after completion of any cannot be located it is recommended that the work invoiced. All materials will remain the customer have the property surveyed. property of ACME FENCE until all invoices ACME FENCE will assume the responsibility for pertaining to this job are paid in full. The having underground public utilities located and customer agrees to pay all interest and any costs marked. However, ACME FENCE assumes no incurred in the collection of this debt. responsibility for unmarked sprinkler lines, or any other unmarked buried lines or objects. The customer will assume all liability for any damage caused by directing ACME FENCE to dig in the immediate vicinity of known utilities. The final billing will be based on the actual footage of fencing built and the work performed. Partial billing for materials delivered to the job site and work completed may be sent at weekly intervals. Adjustments for material used on this Approved & Accepted for Customer: I Contract Amount: $ 3195.00 Customer Date Down Payment: $ 795.00 Accepted for ACME FENCE: Balance Upon Completion: $ 2400.00 Salesperson Date I ,. .''•sI " 813-78"020 0-0021. 'City of Zephyrhills PelTtiif Application Fax-813-78 a,. •Bulldtrag.Dep.rtmen# . - _ ., ,. , is r',• ia. �;r';:;.,. 'i.',`�" ,:� .<' :y 1. ii r W. r D'to Received h�r J r P.hone.,Contat;t,forP..errttittlri , 7.,. .:. •'�-t. .. :>G'..u.5'S:,-r.;use 1. L+t.;,^ro.�i'. .��..:.;l,.G;n(-C'y r;" ?,:;'-f°t,., u.- r..» a,i�,f:' ��y n f'••, i Y.: .'P.':}. Owdgr s.Na` a >> f t ,d ,bw.r}sr�,1•earlosNt�berL,Y:� ' _ �_.•'. � � = «,t'' t:t' ,1 �•,psi".~' 't �7 f .$. //��,,���� I ^s nirs�aa+ a d ��� Q n Om y l., Fee Simi 1dTitletioliler-Nalr►e ;r r :;:. ,Ow'ner PhartejNuq�t�r..,.,,„ Fe®$Iriiplti:TitleholdeiA�t�tess' t''' - 3 JOB AEy[i S$ .'�< i' -,. - t {IIb i k :. suBD m slord _ I�.10=:f •.d': {O T7 NEWF "PRCi;ERTY a tdQTtrrE .:�,7 : 1,',`:':••` ei': ).' f' �-•—� <WO <RKaPRGPOSED =;s,_ ., NfW GONSTR"< ;'ADD/AC: . °s":�� SIG. Ell: REPAI Y, . OPOSED US +2- fit_ :,,5' :l" 7'":; •.4.^ - - k;;.G� E'�; :$FR ^+-, `e O ��',,zv ::,'• ,.[� ; ... :���,'- ' _^�G M.M.--`,•,.� ;?' t)ttllxfZ r -�.as ":� a r.�� .�'�`-: ,. L. ,i•ii- ..^i ��� TYPE` I:.CMaNSYIttICiON' BL'1DC r . 77 ,r _ :raar Tf: y n�i'"r,� '•'l�':',;Jac` ,- DES4`�II�'� 'O.' OItK ..r BUI 91Y. I E V G lira' ,x h ` •fir :... t r• 1 - ''7� _ _- B'IL 1 � `•U G 4t' ��.. 4. F ,. . 7 ._ - y'':�y�4l�l�ATION:OF3T0'T�T�:CON$TFtt:1.CTlONr-.;- '°`•,. = r� 1 - : 2 , - 1= ERU'ICt���s.. Ft- �' SS'E�t `•R'j�•�C':',,:'�;�� 0 �,• _. ... , _ tA..,.-� �-;• .. .. .. -{���;- :J�;P 0t?�...,;. .fri�2G;�: ,=y . tNr,.,� ..r'' PLUM N�=, r, . QMECHANICAL $; ,.. 1/ALUAFiON OF`MEGHAIICAt:ll `t`Ati:A =GAS Q ROOFING ' ;•--;!II,aSPE_CIAIJ FINISh1Ed FLOOR ELEVi4fi ONS I=LOOb'Z(}'1.'A(2 °t1`t vifs i'`F10'' N 'BUILDER COMAAWP''�ti> 'SIGNATURE EEiXe" BEh,{. rxY.l N', e•. 'f r^ SIGNATURE' a; i% s";REGi$ EtEp , r.:::Y.,'F:iN'f': +5f - :.r r'~ {' p# Adarifts ) Ci"'''s _ t= ,t :Ji r?:i:•r.iti'i•ry.�5 :4'• Cen PLUMBER.: :,>:.,. :.CdMPANY•;;_�• ; : .�.'..: a:�: -'x :h $16NA7URE. . ;: RE ISiE sl <..iYsl;'N'. t'1:.., :.4 cons Ad � L p c I .Se a r i i MEC >ANI O� •,'. FI CAL .Y M. -Sl61VAi•'�UREr•., 'REGls,7(:ttED:'.. qq �Y./�N, FEE'CU" � Y1•N'=�' 'Address'. � ir; CIMPANY• QTHd - ;.Y ,.t.a t SIGNATURE `��cl�ir�i�tS' .Y'l;'1M"'.j. .'-�E'cuRREn'::�, �Y�l,Nir' .. . a';,�r..;;•;;: at, %1aCe11St3#; ;'•ac: •lr ,k'. '.6^:p. L,"�, ''i'- >s• ,•,,.� •.:a., t• .Y.`''e'•';,,.;:,-. 'e+:.ii'•:, t':7P-•»r�- +'., ..,.. - :•,1° f' 'r'•"i':. ,°i t P i Y.)':F'. `9},, �.�:.. rl� .7�kr'f-;�ri''(';_ 'rY•i;,7y-':: ,.�:.':i,':'.`r*- .n:,;s::,.::': rm,,�. t:•?•+:..' ES NTI fi't P `ti 'Z' eLsOfBt'd Fiis`u.° ``'` at,:.r. ^:k' r.:• R iDE AL Minimum.ten(10).wo*106 days.after.submittal:ilatA: Re qutred:'ortsite;:Consttiction Plans,SttiYrr�v�arter'Plan =-viY%SIIC nce ib .ksll&d;*•' SanifaryF•atilitles&1'durnpster,:Site:Wbik Permitfo-a6bd-�#s ij5116rgb.prdjec#s COMMERCIAL -Attach-- com ietesets:df,•ButtdfrigPlans Tu�s�a:LifekSte: t'9't i�;ji,)setotnergy,Forms.•;R�C1.W 13ermit-for;newiislrtrctlort' Minimum ten{10} iorkirig#tlays'.' #ii3r3tfr�11#CfiT:'�!te:�, 264W site,.Criristructlon ihs;SSYn ii�iat8� !lan`sriiif`SiaA�ici�;nsta�led;' '' ` Sartitory'fai litles-8;l d rrrr "ter:;Sl#e 1+Y&Pe ni for:altinew,projects Air comiiaeri ai i+2i}�lie etrtfirm)ust tirseticoirrpllari - SIGNPERMIT Attach:(2)setso`frEnglneerad,Pla'ris •'•'PROPERTY,'.S�JRVY.tegtiir@i9 foraD NEtN t ►nsthrcHoh. „ ._ ::;, Directions: Fill ouvApplication completely.. lOer'&:Confraotor:sign<baotr of applioatlon;'notarit ver$2500,.axNotice.:af'Commencement s.requlr*ed.:.(NCsP.gM'd+�s:o�er s7500) • Agent(for the contractor)or Power of Attomey(for the'owner)would be someone with'notailied letter fmm owrier<Wth 6diliig:seine` GVER-,THE'COUNTEf2 PERMITTING .(copyof'cc6t"*1f1 elayli*01'..,4- yp,'• ;, ;:. " Reroofs'If shingles Sdwers Service Upgrades A/C Fences jOlo'VSurvey/Footags) " Driveways-Not over Counter If on'publlc;roadways..needs ROW i _ i M ons" NOTICE,UF:DEED.RESTRICTIONS: The undersigned understands.that-this permittmay be subject to"deed"restricti which may be:more'restrictive than Courity-regalations. The undersigned assumes responsibilityfor-compliance with any applicetale tiqed,restrictions 'UNt10EftED"CONTRl4,C fORS"'AND°`CONTRACfiQR'R SPONSiBILiTiES:�'tf=the�owner`hai s- fired;a''contPactor~or" contract9rs,to undertake,work;-,#hey�ia�be�.req"uired�to'be licensed,in-accordance..with.state,and locat.regulatioris,:of the- colltractor is riofilicensed:as required by law, both the.owner-and°contractor~,may-be'cited-for--a-misdemeanorviolation under:,state,:taw.r If the.�a dvlsowner-,,or intended*contractor are-uncertain"as to what-licensing requirements.may applyifor,#tie. Intended:vtror-k;they are' e'tl;to-contact the.Pasco County Biiildirig°Inspection Divisior>=Licensing.Section at727-847- .8009. Furthermore,_if,•the,own er;.,,ha's;�l lretl.,la:;eonteactor or contractors,. he is advised to. have the.4cantraCtor(c),�sign:,,- port'ions:af.:the".°'cortractor Block" of thi$.:,applfcatlt�.t�__for which #h'ey.wiit.;tte.responsble." If you, as the"owner sign as the contractor, that may be"an:indication that he.is_not properly"licei sed and is not entitled:to"permitting,privileges in Pasco _. _ . ". - TRANSPORTATION;IMPACT/UTIL-ITIES.IMPACT AND:RESOURCP-RECOVERY FEeS:-The undersigned understands that Transoddailon``Im act-Fees-and-Recourse-Recove"ry-Fees:"may.apply-to=the.:construction:of:new buildings, thangePoV" use in existing buildings, or"expansion®t eicisting'tiuilding , as specified in`Pa'sco`County 0"rdinance number 89-07•and 90A.7;:as.amended:::;;The�:undersigned•ai_so understands,.�that�suet fees,.as,may be;due,,w{i.be,iilentified at4he4lniei,of'. permitting.;, It is further uncierstooditat.{1'iain'sportation:Impact Fees and Resource Recovery Fees must be paid:prior. to receivin ,aftertificate of p upanc. -t9r,,fnal,p6vuer release. lf'the-p'roject?:does,ndtiinvolve a,cettificate"of,occupancyaor,::• final--power.release;.the:_fees,.must:be,_paid prior to permit-issuancea> Furthiormore;=,if Pasco County Water/Sewer impact fees:are::c9ue;they=st tie;paid:.p for"to,permit?is&maned-irfaccordancewith!applicableaPasco Countyordinances:, CONSTF UCTIOPd-L EN LAyil: Chapter 71'3;g tor,,itia$fat"utes;as,;amendedj; •if vaivation of work is$ �5,00.00;orrmore,_1 certify:.#fiat:i;.Tfhe applicant; have been provided-.will;a-•.copy.:.al;..the, "Flonda.:.C4n6tructron:Lien Law-=Homeowners Protection.Guide"_prepared:by the.Florida Department of Agriculture=and-Consumer.Affairs. If the applicant,is some9ne. ottiertharrthe'aowner';t;:certify thatl}xave abtaine'd"a~copy:ofJb rabovO��described,,document:-and promise:in.good Earth to deliver.]t to4he."o-wner":prrouto commencementr;,�- ._ " . . . CO,NTRR,ACTDRIS/OWI4Ett'S�AFF,10.;Vl`� ;'f:ceriN:that,all�the�nformaiion°in`thi's``application-.is-accurate�,and1haf�all-work' will be one come"fiance`wifh all a li�aabfef laves r'e'ytiatin .tconstructioii;` onin"ranch:iand'tlevelopment. Rppllcati'dh�Iis p pP .:. .. : 9 0. g hereby made to obtain a permit to do"�xworkJ;;fin fir stailation:fas lrtdiiated. : "I "certify that no iivork or iristallatioii-•has commenced prior1o, issuance-of a permit and that--all:work wlii*be performed;to°•meet standards.of all-laws regulating " consti tietion;'County aiid City`="codes; zoning;.regy ations,•antf Iiihd>'adeuelopmenf regulations sir;'.the jurisdiction:_,:!;also s certify-that I under6tand4hat the regulations of other:government:agencies':may,.apply-:.to..the:lntended work, and that it is my.responsibility.to identify,what actions•.I must:take.to be in compliance. Such agencies-include-but are not•.i mited;,i;,o:­ Department of Environmental Protection-Cypress' 8ayheads; Wetland Areas and-:Environmentally Sensitive .-Lands,Water/Wastewatgr.,'l reatmQnt.; Southwest Florida. !!Valet' lariagemetit C}istrioiWells "Cypress 'Bayheads, Wetland Areas,�"Altering Watercourses. Army Corps.of Englneers*Seawallsfbocks;Nayigable:llllaterways.: • Department of Health A'c;Ref 66ilitafte .S.,erviees/Environmental Health-�tlnit-Wells, Wastewater Tr,.eaJm,0nt,. Septic Tanks. ' US�Erviroim+itri#aLProfeotiotgency-�?I,sbestos.abatert2ent�. - Federal Aviation-Authi3ritjr.Runways: I understand::that'the,.following.restrictions.apply•tothe:use;caf,fll:. - " Useof �esslyipermitted. If the-- ill-material--ie,.to.be-used- in:Flood"Zone qA",' it'asvttnderstoiod�that-.a--drainage.plan•addressing"a .. ",:: p a., � p p Y p"comp nsatingvvottlmerwillbe::suliriiitted.at'tirne,.of:. ,ermiftin which'Is re arefd-b.'a "rofessional:engineer licensed iy,the:.State-ofiFlon a-. If the"fill-material•=is to-.be•used:".in.:Flood-:;Zone°A�iir� ofection with a permitted building- using sten„wa constru donb y 1t e�areawithih the.stem wall. • IUfill-materiot°is'to.ibe,.used, irr.'any;area, 1.certify=that use cif sUdh-fll--wiil:~:not-adversely-affect .adjacent propsrties.. lf,use_,of IIi'l.6904o,adversely::affiErct::a"-jacentyprgper.ties,:the owner.may..'be„cited,for violating the conditions:of'the building permit isscted under.the attacttetl:permtt applicatron; for'lots-less than one (1) acre'.whrcti.are.,dlevates!py"fll,art ettgrrieered drarriagerpJah is tequlfed. If I;am;the AGENTkF'd HE-OWNER; l pro'mis,,e:ih-.goon:faitlt�ta-"•inftjrm:the ovrner.of the.permitting,conditions set:forth"'in this''affidavit prior to commenoinb:construction. I understand that:a't6o'6tdte permit.may be required for"electrical work, plum' ing igns;-wells;:=pools";`air cojirditionlne;,:0as,-or:other-ihstillations-not specifically.:inciuded.-in..the:application:'"'A permit.issued"shall,be'construed to:be a license io,proceed:.with,the-work-and novas authority to.•viotate, cancel,"alter, or set�as'ide any=provisions;�if�the;#echnicalYcodes;wnor:sh'all:assiarrce af:a permit-prevent"the"BuildingOfficial from-thereafter• regiriring,a-corre009n-of errors16 plans,constriaetian"or violations°af.any:c odes: Every permit issued:shall..become`invalid. unless,the_.work„authorized„by.such�ypermlt is..commenced within'six months of:permit issuance, or if•work'authorized.by the permitµis;'suspended-or-akiandoned.for a;.period;of;six(6)~mdnths=after.-the_tii.ne-..the:work:is-:commenced: An•e)ten"iron m'ay.be requested;in:writing,,fr9M._0q Building Official for:, ,period not.to exceed"ninety(90) days and will..-demonstrate justaple cause for:,the extenS'icn;: f_vvorkjceases ftir n'inety90}ciinsecutive days;-the job is considered abandoned,, WARNING„"TO.,OWNER: YOUR:;F;AiLURE'.TG-.--RECORD:A;NOTICE-.OF COMMENCEMENT-MAY RESULT-1N YOUR PAY•II+tC�;TfICEFORIQdIt'Rai{YMEN�CSTO'YO:UftwPROP,ENTY;.�lF Y,OId�II`f�lN1Y `O OBTAMNIN'ANC.ING,;CNSULT. . WI I ^Ynua,1 ZENDER�'ORgAN-AATa'ARNM-2 139 OftE�;REC.ORDING.�YOU 71.'" ..CO.MMENCEIVtENT:_ -= FGORIDA�jURAT'4F'.S:117:0,3J' :. OWNER',QftAGENT'" " _ CQNTI�Ad.f.0 Subs,rtb`ud:aj0d.sorri;ta(oraffirej)ksfore m.Q this`:_ Subscribe an�syrror :tt,(9'r, f$riT�eii}:tiefore me.this: Who is/are personallyknown tome or lid pr6b0d d Whoi lI lard p'eis""'llV kHbWh-t&me*'ha's/have produced` as identification. `aslidentihcatiom-' Notary Public NdtaryPubllc.-- Commission No. CommiWon•.No.. :•. 1 , Name of Notary typed."Printed"or stamped Name i f Note ryityped;•prl[itedF.orstamped '