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Home My WebLink About06-5849 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT SINGLE FAMILY RESIDENTIAL 5849 Permit :5849 Issued: 6/01/2006 Permit Type: GENERAL BUILDING PERMIT Class of Work: SITE WORK Proposed Use: SINGLE FAMILY RESIDENTIAL Sq. Feet: Est. Value: Cost: 5,000,000.00 Total Fees: 1,380.00 Amount Paid: 1,380.00 Date Paid: 6/01/2006 Name: LARKIN CONSTRACTING INC Addr: 6001 N 50TH ST TAMPA, FL 33610-4812 Phone: 813621-0851 Lie: Phone: Work Desc: SITE WORK - SIL VERADO - ALL 4 PHASES Address: EILAND BL VD-SIL VERADO ZEPHYRHILLS, FL. Township: Range: Lot(s): Block: Section: Book: Page: Subdivision: SIL VERADO Parcel Number: M RO DEVELO E ROUP 2502 ROCKY POINT DR #1050 TAMPA, FL 33607 813288-8078 DUCTS INSTALLED PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB DUCTS INSULATED LINTEL PRE-METER WATER SHEATHING FRAME MISC SEWER MISC INSULATION WALL MISC MISC, MISC. INSULATION CEILING MISC, MISC, MISC, DRIVEWAY MISC. MISC, REINSPECTlON FEES: Reinspection fees will comply with Florida Statute 553.80 (2)( c) when extra inspection trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections called d) work not ready for inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible. 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, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same "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." \ t~~._-~ - &~ ~NTRACTORS SIGNATURE PERM~ CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813-7~0 City of Zephyrhills Permit Application Building Department Fax-813-780-OO21 Date Received Own.... Name €1 (i 0 P DA: LOP f'\." t-')' CO n. " '-' f' Owner'. Add..... IdS 02- (2 OC ~ 'f \>C\.lJ;: .oIl \ () ') Q Fee SImple TItleh0Ider Nama h ~M\" I), f L, !? ~ Co 07 Fee Simp" TIlIeholder Add.... I Owner Phone Number Owner Phone Number I ( f\ v... Owner Phone Number I Q.\\J 0 ~ \ LUc. RF)DO JOB ADDRESS I E.\L?\~D I PARCEL II>> I I E3 D D SUBDIVISION WORK PROPOSED B o o I snc l,UO K - I SQ FOOTAGE I f:\. ~ L '-\. NEW CONSTR INSTALL SFR BLOCK ADDIAL T REPAIR COMM FRAME PROPOSED USE TYPE OF CONSTRUCnON DESCRIPTION OF WORK BUILDING SIZE ~ BUILDING 1$"~O(2?O, 000 , . D ELECTRICAL 1$ D PLUMBING 1$ D MECHANICAL 1$ D GAS 0 FINISHED FLOOR ELEVATIONS I I I I I D I LOT # I o o o (OBTAINED FROM PROPERTY TAll NO'/lCE) SIGN 0 MOVE 0 DEMOLISH OTHER I STEEL 0 p~, f'o)<> IoZ <::> HEIGHT I OTHER L- AMP SERVICE VALUATION OF TOTAL CONSTRUCTION w.R.E.C, D 1:::::::1 PROGRESS ENERGV ROOFING VALUATION OF MECHANICAL INSTALLATION SPECIALTY 0 OTHER FLOOD ZONE AREA DVES DNO i.. Lf\QIl-\~ VIN BUILDER SIGNATURE Add..... ELECTRICIAN I SIGNATURE Add..ss I PLUMBER I SIGNATURE . I COMPANY REGISTERED License # ~GC04~'-i92. l.....Y..!.1LJ FEE CURRENT Lt..!.!!...J License # Ad_ MECHANICAL I SIGNATURE . Add.... I OTHER I SIGNATURE . Add.... I COMPANY REGISTERED l.....Y..!.1LJ FEE CURRENT Lt..!.!!...J License # COMPANY REGISTEREO l.....Y..!.1LJ FEE CURRENT Lt..!.!!...J License # COMPANY REGISTERED l.....Y..!.1LJ FEE CURRENT Lt..!.!!...J License # Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) WOI1<ing days after submittal dale, Required~, Conslruction Plans, Sanitary F~ & 1 dumpster Attach (3) sets of Building Plans; (1) set of Energy Forms, Minimum ten (10) WOl1<ing days after submitlal data, Requirad onsite, Construction Plans, Sanitary Facilities & 1 dumpster All commercial requirements must maet compliance, Attach (2) sets of Enginaerad Plans. -PROPERTY SURVEY raquirad for all NEW construction, RESIDENTIAL COMMERCIAL SIGN PERMIT D1rac:t1on.: Fill out application completely, OWner & Contractor liOn back of appIica1ion, notarized If over $2110O, a NotIce of CommeI""",oentls raquIrad. lAIC ~ ........ $5OlIlIl Agent (for tha contractor) or Power of Attorney (for the owner) would be someone with nolatized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades AJC F9I1aIs (PlotlSurveylFootage) DrIveways-Not over Counter if on public roadways..needs ROW NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions" which may be more restrictive than County regulations, The undersigned assumes responsibi/ity for compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work. they may be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law. both the owner and conlractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact the Pasco County Building Inspection Division-lioensing Section at 727-847- 8009, Furthem1ore. if the owner has hired a contractor or contractors. he is advised to have the contractor(s) sign portions of the "contractor Block" of this application for which they wiU be responsible. If you, as the owner sign as the contractor, that may be an incflC8lion that he is not properly licensed and is not entitled to permitting privileges in Pasco County. TRANSPORTATION IMPACTIUTIUTES "'ACT AND RESOURCE RECOVERY FEES: The undersigned understands that Tn1I"""",1wtiuiI1mpad Fees and Recourse Recovery Fees may apply to the cons1ruction of new buikflllgs. Change of use in existing buildings, or expansioo of existing buildings. as specified in Pasco County Ordinance number 89-07 and 90-07, as amended. The undersigned also understands. that such fees, as may be due. wiD be identified at the time of pennitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a "certificate of occupancy" or final power release. If the project does not involve a C8ftilItaIe of occupancy or final power release. the fees must be paid prior to permit issuance, Furthennore, if Pasco County W8IerISewel Impact fees are due. they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION UEN LAW (CIIItpIIr 713, fIortdII ......... _ .....Ided): If valuation of work is $2.500.00 or more. I certify that I, 1he appIica1t, have been provided wilh a CX)JIY of 1he "Florida Construction lien Law Ilomeowner's ProIection Guide" pI8p8AId by the FIonda Department of AgricuIIure and Consumer Affairs. If the applicant is someone other than the "owner", I 08l1lfy that I have obtained a CX)JIY of the above described document and promise in good faith to deliver it to the "owner" prior to conll'll8llcemenl CONTRACTQR'SIOWNER'S AFFIDAVIT: I certify that all the information in this appk;alion is ec:ante and that all work wRl be done in compliance with all applicable laws nlgUl8Iing constJuction, zoning and land del.Blopmenl AppIic;atioI. is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or instaIaIion has commenced prior t) iIleuMc:e of a permit and that all wort wiI be performed t) meet standaIds of al laws regulating consbuclion, County and City codes, zoning r&gulaIions, and Ia1d developmehl reguIalions in the jurisdiction. I also certify that I ..,derstalld that the reguIaIions at other government agencies may apply 110 the inIIllnded wort, and that it is my responsibiIlty to identify what actions I must take 110 be in oompIIance. Such agencies include but are not limited to: Department of EnvironmenIaI ProJection..Cyp Bayheads, WeIand Areas and Environmentally Sensitive lands. WaterIWastewatel TI1l8tmenl Southwest F\orida WIlIer Management District-Wells, Cypnlss Bayheeds, VI#atIand Areas, Altering WatercounIes, Army Corps of~, Docks, Navigable waterways. 0epar1ment of Health & Rehabilitative SenriceslEnvironmental Health Unit-\l\lells, WasIewater Treatment. Septic Tanks. US Environmental Protection Agency-Asbestos abatement. Federal Aviation Authority-Runways. I understand that the following restrictioIlS appJy to the use of fill: Use of fiU is not alowed in Flood Zone 'V' unJess expressly penniIlIld. If the fill material is to be used in Flood Zone "A". it is undersIood that a drainage plan addressing a "compeIlSating volume" wiI be submitted at time of permitting which is prepared by a professional engineer licensed by the Stale of Florida. If the fill material is to be used in Flood Zone "A" in connection with a pemitled building using stem wall construction, I certify that fill will be used only to fill the ... within the stem wall. If fill material is to be used in any .... I certify that use of such 1iII will not adversely aIfBct adjacent properties. If use of fiN is found to adversely affect adjacent proper1ie&, the owner IJlIIY be citIId for violating the conditions of the building permit issued under the attached permit 1IppIicaIIon. for Iol8 IeIa than one (1) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWIIIER, I promilIe i1 good failh t) inform the owner atlhe peolllillil", oondiIions set forth in this alId8lIit prior t) ..o.}~._lCing canstruction. I ..,dlll1ltalld 1hat a ......, permit may be requAd for eIeclricaI work, plumbing. signa, wells, pools. .. ~liin", gas, or other illsllTlro,1S not specilicaIIy incbied i1 the appJitation. A panni( issued IhaJI be construed to be a IicenIe t) proceed with the work and not as authority to violate. cancel. alter, or set aside any provisions of the lechnicaI codes, nor llh8II U&lce ate permit prIMIIll the BuIlding 0III::iII tam 11I61 - requiring a correction of errors in pJans, consbuclion or vioI8IIana of any coda Ewry permit issued .... ..... invalid unless the WOI1t authorized by such permit is conwnenced wlthin six ~ at permit ....... or if work 8UIhoriz8d by the pennit is suspended or abandoned for a period of six (6) IYIllI1th& after the time the work is commeoc.ed. An ll!ldteIlSion may be 11IqU8St!ed, in writing, tam the 8uiIding 0lIiciaJ for a period not to ..... ninety (110) d8p and wit demonslrale justifiable cause for the extension. If wort 088ll8S for ninety (90) consecutive days. the job is coneidered abandoned. OWNER OR AGENT Subscribed and sworn to (or aIIirmed) before me this by 'Mlo isfare personally known to me or h8II/hImI proclJced as identiIicaIion, WARNING TO OWNER: YOUR FAlWRE TO RECORD A NOTICE OF COIIIIENCEMENT MAY RESULT IN YOUR PAYING 'TWICE FOR IMPROYEIIENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COIIIIENCEIENT. FLORIDAJURAT(F,S 117,03) ~""lI2IV.":" C.:J_"'7/t~c.rl/V'" /r~,..J(:' . CONTRACTOR~ - ~ ~ S~~~'t, and by (orv~ berore ~ ~ IJ '.If' r DI9 Y 0 t: /7'lI9y Who isIlre peI'lIOIllIIIy known to me or h8II/hImI proclJced -- ~~.~- C ~,;; . jilrG Commission No, Name of Nolaty typed, prinIecI or -..ped Name of Notary typed, printed Sl\j[~))6 '5 'ln~ W-~X\.lL / // ~V 'y // r~ /. \ 'v \-1 / "V"' , ,~ XV 'SquareFeet , 0 'f". 'rrJ'No/\~ Q7ojl.fUc. Dollar Amount Valuation '?>CJ'l, ?)~ ~ -- l,?~\)\-"Y~ I "'- ,;9 7' ",0\. I J. '\ ..1.' \v (y ," ,I..-. . -c..... . '0"/ .,~ ,'- '\ ,\, \./ Building Electrical Plumbing Mechanical ~i)o~ Connection Fees Sewer Water Meter School Impact Fee Transportation Impact Fee Park Impact Fee Public Safety Impact Fee ~ D) CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 5851 Permit Number: Permit Type: Class of Work: Proposed Use: Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: 5851 IRRIGATION IRRIGATION NOT APPLICABLE Address: 6460 ASHVILLE DR ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: SILVER OAKS VILLAGE Parcel Number: 03-26-21-0220-00DOO-0080 6/08/2006 35.00 35.00 6/08/2006 INSTALL IRRIGATION SYSTEM VILLAGE QUARE BUILDER 6460 ASHVILLE DR ZEPHYRHILLS, FL. 33542 Phone: ~a I ~ ,~,Lf / \ (\ 0/U \" lo" ~ REINSPECTlON FEES: Reinspection fees will comply with Florida Statute 553.80 (2)( c) when extra inspection trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections called d) work not ready for inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible. 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, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same "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. II NO OCCUPANCY BEFORE C.O. ~d~TURE ~M. CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED / PROTECT CARD FROM WEATHER 813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Recerved u.. (t-{,~ Owner Phone Number Owner Phone Number I Owner Phone Number I Owner's Name Owner's Address Fee Simple Titleholder Namel JOB ADDRESS Fee Simple Titleholder Address I I tfl4 {PO I~ 1-1/.. OJc~ B PROPOSED USE D TYPE OF CONSTRUCTION D DESCRIPTION OF WORK I SUBDIVISION \ht.L~ I A~~ Y'L-L~ ~^- PARCELlD#1 O':S- d(O- 21- 0220 - ()O boo - OO~O (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D LOT # WORK PROPOSED r-=:J ADD/ALT D D REPAIR D COMM D OTHER D FRAME D STEEL D OTHER I lp<;<f~L \ an. ( 'A-r- \ Ot-' ~~~ BUILDING SIZE I I SQ FOOTAGE I I HEIGHT I I 1111"'111111'111111'11111"'111"'111111"'111111""111111111111"111111111111111,1'111"11111"'1111111"1'111111111111'111111...1111111'1'1111 NEW CONSTR INSTALL SFR DEMOLISH BLOCK 1$ I 1$ I 1$ I D MECHANICAL 1$ I D GAS D ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO 111I11111111111111111111111111111111I111111111111111111I111111111111111111111111111111111II11111111111111111I1I11I11111111111111111I11111111111111 I I I I : I I I I D BUILDING D ELECTRICAL eM PLUMBING VALUATION OF TOTAL CONSTRUCTION AMP SERVICE D PROGRESS ENERGY D W.R.E.C, VALUATION OF MECHANICAL INSTALLATION COMPANY REGISTERED BUILDER SIGNATURE Y/ N FEE CURRENT Y/N Address License # ELECTRICIAN I SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N Address License # Address MECHANICAL I SIGNATURE Address I OTHER I SIGNATURE Address I License # 111111111111111111111111111111111111111111111111I1111111111I1111I1111111111111111111111111111I1111111I11II1111111111111111111111111111111111111111 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster Attach (3) sets of Building Plans; (1) set of Energy Forms. Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Sanitary Facilities & 1 dumpster All commercial requirements must meet compliance. Attach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for all NEW construction. 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000) Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades AlC COMPANY REGISTERED ~IL~ trL!2-, " . .... N FEE CURRENT i(!) N I _ License # I (DO .~ 0 'i I PLUMBER SIGNATURE Y/N FEE CURRENT Y/N License # COMPANY REGISTERED Y/ N FEE CURRENT Y/N COMMERCIAL SIGN PERMIT Fences (Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restri~tions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any. applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with state and local regulations, If the contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact the Pasco County Building Inspection Division-Licensing Section at 727-847- 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and 90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law-Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to commencement. CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment. . Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. Army Corps of Engineers-Seawalls, Docks, Navigable Waterways. Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment, Septic Tanks. US Environmental Protection Agency-Asbestos abatement. Federal Aviation Authority-Runways. I understand that the following restrictions apply to the use of fill: Use of fill is not allowed in Flood Zone "V" unless expressly permitted. If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting Which is prepared by a professional engineer licensed by the State of Florida. If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that fill will be used only to fill the area within the stem wall. If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced: An extension may be requested, in writing, from the Building Officia~ for a period not t~ exceed nin~ty ~90) da~s and Will demonstrate justifiable cause for the extension. If work ce~ses for nmety (90) consecutive days, the Job IS conSidered abandoned. 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. FLORIDA JURAT (F.S, 117.03) CONTRACTOR Subscribed and sworn to (or affirmed) before me this by Who is/are personally known to me or has/have produced as Identification. OWNER OR AGENT Subscribed and sworn to (or affirmed) before me this by Who is/are personally known to me or haslhave produced as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed. printed or stamped Name of Notary typed. printed or stamped