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HomeMy WebLinkAbout11-11811 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (si3)�so-oozo 11811 . BUILDING PERMIT Permit Number: 11811 Address: 5109 9TH ST 38620 2ND AVE Permit Type: RE-ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-20600-0015 Improv. Cost: 3,750.00 Date Issued: 4/26/2011 Name: SAMPSON, GILBERT & ANNA Total Fees: 55.00 Address: 39028 3RD AVE Amount Paid: 55.00 ZEPHYRHILLS, FL. 33542 Date Paid: 4/26/2011 Phone: (813)862-3813 Work Desc: REROOF SHINGLE DUPLEX N IAL 55. 0 O �� �� V C C � �� � IN TAPE JOIN OF...1 ,NSP . � FINAL "' L �I C � REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to any one 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 � 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 properly 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 improve ents to your property. If you intend to obtain fnancing, consult with your lender or an attorney re r rding your noti of ommencement." CONTRA SIGN PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received Phone Contact for Permittin �� � Owner's Name �-4►�'1 L �� � .� 0 Owner Phone Number A� J e�(/p� — 3� (� Owner's Address � �� Owner Phone Number Fee Simple Tltleholde� Name Owner Phone Number Fee Simpte Titleholder Address J08 ADDRESS �Jl �� � � SI-• � � n ��� � �x LOT # C� SUBDIVISION PARCEL ID# � L Z�G' � ' �-�IC � �Lv� ` ��lS (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED B W TALLSTR e REPAIR ��_�N Q Q DEMOIISH PROPOSED USE Q SFR Q COMM � OTHER Vh� � TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL Q DESCRIPTION OF WORK '�lV" � . P" �2 � �j �;T� 1 �� � � C � p t� �C. �( � BUILDING SIZE SQ FOOTAGE ����! HEIGHT �BUILDING $�{�-� �� . VALUATION OF TOTAL CONSTRUCTION 1 DELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. �PLUMBING $ OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION - I(" t I � QGAS � ROOFING Q SPECIALTY 0 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO BUILDER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N Address ' License # ELECTRICIAN � COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N Address License # PLUMBER COMPANY SIGNATURE REGISTERED Y I N FEE CURRE� Y/ N Address License # MECHANICAL COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N Address License # OT R -6�NIPANY �� �D �, .� , SIGN REGISTERED Y/ N FEE CURRE� / N Address �� l� �� 1( C� License # �C- � � �� RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. **"PROPERTY SURVEY requlred for all NEW construction. Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over;2500, a Notice of Commencement is required. (A/C upgrades over 57500) "'' Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs if shingles Sewers Service Upgrades A/C Fences (PIoUSurvey/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" restrictions" 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 cor��ractor 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, wiil 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'SIOWNER'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 buifding 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 Iots 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 Official for a period not to exceed ninety (90) days and will demonstrate justi�able cause for the extension. If work ceases for ninety (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 F IMPROVEMENTS TO YOUR PROPERTY. IF YOU TEND TO OBTAIN FINANCING, CONSULT WITH YOUR L N OR AN ATTOR EY BEFORE RECORDING YO NOTICE OF CO M CEMENT. FLORI URAT ( S. 7.03) OWNER E CONT Subscribed an to (or affirtne ore me Subscribed and swom to (or a ) before m s by bY Who is/are personally known to me or has/have pro uced Who is/are personally knovm to me or has/have produced as Identlflcatlon. as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped � ���� - ��3a� �a �;; �' ; �a �� , . �v�" �� �7�� � �� � � 1� � �1�'ir ���,� � °� � .4 Division of Ryntari Construction, Inc. � �� � � ,�, � � . "� Proposal # ihr. 36413 SR 54 • Zephyrhills, Florida 33541 , Phone 813-782-6094 • Fax: 813-788-6773 Estimate # _!��_ License # CCC 1325505 Job # .�(}f�,y '�-�+��i-�d�+t��-�'it�i�f� Also, Serving the Central and East Coast of Florida (7�663� t;ustoiner: � n(lc� ��v�S��f\ Date: � � i Address: �, � ` � �-Y� , l-i. V� CitY:.�t1�3'"�. ��� Lip: ��,i y � f Ion►e #: � � � ' ���v;� - .�'S�L� Cell #:7(Uv -� 1� 4 y 3 � Business #: �-mail Address: - �,;d Com�lete tea.r off of existing.5�,.�� � Additional ltems: .�T.. �-+��� L-'�` �}���y �ecure a.11 loose roof decking as needed accoY•ding .� � •=� to Floi�da Building Codes ��, � � a� � � 1� � , , ._ _. L ��� y ��� ""`."' �� Roof c� i�l with _�3C7 � \} �a.��` � �tii'Install new valley metal with galvanized metal `Z �� �Y � �� �, ��, �7'Install all new � " drip edge color:�,1�, •}� � l:1'fi�stall all new lead b�ots _ _ .,5�;�� �,;, C;r�\��'i : �1`���,�,ti �nstall all ilew � year fungus-resistant shiiigles �Shingle br•and/colox•:CI��L� Y`i".• 1� �. �c'�J 'y�C�3 ��t� WazYant3'Pac�kage. �All roof i•elated debi•is i•emoved from jub site C�'�Ail matenals, labot• aaici permits furnished Total bid price $�J �.� C� • W E�tra's �3ad �lywood rel�laced at a cost of $����� per sq. ft. in the xoof field. All other wood work/additional labor, such as, but not lunited to, valley rebuild'u1g, raftei• replaceiuent, etc. will be a rate of $��" .`�� per man hour plus the cost of �taterials. UI' �_3 �_� � L�= °- wh;c.\ •�uc; �s Lt�SS THIS BECOI�IES A BINDING CONTRACT UPON ACCEI'TANCE OF PEOPOSAL. PURCHASER ACKNOWLEDGES RECEIPT OF A COPY OF THIS CONTRACT. 1. All n�terial is guarauteed tu be as specihed :uid completed 'u� a substantial worlmunlike n�uuler. 3. All <�greeiuents contuigent upuii sh�ikes, accidents or delays beyo�id ow control. Owner td carry Iire, huiricaaie a�id other necessary insw�ance upoii above work. 3. I,abor wairaiity does not cow>r damage to roof's caused by light�tiiig, hurricar�e, tornado, hailstorni, impact of foreign objects or other violent storm or casualty damage to roofs due to setileiueut, clistoition failure or rracking of roof deck, walJs or foiutdation of a build'uig. �. Wa�lmia�t's caupei�sation and public liability u�sivance on above work to be taken out by RYNIAN ROOFING, INC., a Division of Ryman Const�vction, Inc., or it's subconL�•actots. 5. RYMAN ROOF'ING, INC., a Division of Ryiu;ui Coi�slluctioii, Lic is not respoi�sible to provide any materials or to perfoim any work other than what is described above. Replacement of detei•iorated decldng or fz�ti�ia boards, is not in�luded u�d will be chruged as azi e�•a wiless otheiwise stated herein. G. Tltis conti��ct is subject to i'mal upproa:il by HPMe1N ROOH'INU, INC'., a Division of Ryman Coi�struction, Inc and is the entu•e �reement of t11e paities a�id no otlier wiitten or other fortus will recogiuzed. 7 A ch�uge of 1.5% will be uiacit� on all mtipaid balrmces �il'ter �30 days, plus ch�u•ges ulciured for non-payment procedtu�es, plus attomey's fees. 8. A 4% processu�g Yee will be ailded to all credit card ordeis. Ryman Roohng, Inc., a Diviaiui► of Ryman Construction, lnc. will nut be responsible for any damage to septic tanks, sod, sY�rubbery, paint, satellite sigiialloss, sprinklers, conc•a•ete drives or a�iy underground pipu�g. Yaytpent Schedule Pxynuent Method: * Acceptance of Proposal STATUTOUY NOTICE REGARI�ING nN�TRUCTinN LIFNS• ACCORDING TO FLORIDA�S CONSTRUCTION LIEN LAW (SECTIONS 713.001-713.37, FLORIDA STATUTES), THOSE WHO WORK ON YOUR PROPERTY OR PROVIDE MATERIALS AND SERVICES AND ARE NOT PAID IN FULL HAVE A RIGHT TO ENFORCE THEIR CLAIM FOR PAYMENT AGAINST YOUR PROPERTY. THIS CLAIM IS KNOWN AS A CONSTRUCTION LIEN.IF YOUR CONTRACTOR OR A SUBCONTRACTOR FAILS TO PAY SiJBCONTRACTORS, SUB-SUBCONTRACTORS, OR MATERIAL SUPPLIERS, THOSE PEOPLE WHO ARE OWED MONEY MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN IF YOU HAVE ALI�EADY PAID YOUR CONTRACTOR IN FULL. IF YOU FAIL TO PAY YOUR CONTRACTOR, YOUR CON1'RACTOR MAY ALSO HAVE A LIEN ON YOUR PROPERTY. THIS MEANS IF A LIEN IS FILED YOUR PROPERTY COULD BE SOLD AGAINST YOUR WILL TO PAY FOR LABOR, MATERIALS, OR OTHER SERVICES THAT YOUR CONTRACTOR OR A SUBCONTRACTOR MAY HAVE FAILED TO PAY. TO PROTECT YOURSELF, YOU SHOULD STIPULATE IN THIS CONTRACT THAT BEFORE ANY PAYMENT IS MADE, YOUR CONTRACTOR IS REQUIRED TO PROVIDE YOU WITH A WRITTEN RELEASE OF LIEN FROM ANY PERSON OR COMPANY THAT HAS PROVIDED TO YOU A"NOTICE TO OWNER". FLORIDA'S CONSTRUCTION LIEN LAW IS COMPLEX AND IT IS RECOMMENDED THAT YOU CONSULT AN ATTORNEY. , I ACCEPT THIS PROPOSAL AND HEREBY RTIFY T I HAVE READ AND F'[JId�Y UNDERSTAN THE P OVISIONS OF THIS CONTRACT. Purchasei•• �%�' '`����i c3 (31--- Date: `-'" �1 �.� Yurchaser: Estiinator: -- �� �C i'Yl � �. ASPHALT SHINGLES 2007 �BC PRODUCT APPROVALS MANUF�ICTURER PRODUCT TESTS PASSED MIAMI-DADE FL # . LESS THAN 11A MPH 110 MPH ANO NIOIiER ASTM A3TM TAS ASTM ASTM TAS D'3981 D•7158 107 D 9181 D 7158 1G7 CLASS 0 CLASS Ci CLASS F� ClA5S G CERTAINTSED CLASSIC liORiZEN X �•� CARRUU3E HOUSE x �•� CENTENNIAL SIATE x �•� ORAN� MANOR X 8�44.1 LANOAAARK x �•� lANOMARK PLUS X �•� LANOMARK PREMIUM x �•� LANOMARK TL' X + 64�4.1 PRESIDENTIAL SHAKE X 3444.1 ' PRESIDEPFTIAL 3HAKE TL X 6444.1 TTERAS � X 'J444.1 i PATRIOT X sM4.1 QAP�ELK� ROYAL 90VERElGN X • 10114.1 CAMELOT ' ' X 10124.1 CAPSTONE ' � X 101l4.1 ' COUNTRY MANSION . X 1Q124.1 • GRAND CANYON X 101;4.1 GRAND SEQU0IA X t01Z4.t GRANO SIATE X 10124.1 ORANO TIMBERLINE X 10124.1 . TIMBERLINE ARMORSHIELD II ' X 10124.1 TIMBERUNE PRESTI�UE f3RAN0E X 10124.1 TIMBERUNE PRESTI�UE 30 _ X 10124.1 TIMBERLINE 9 X 10124.1 TIMBERUNE PFtE3TiQUE 40 X 10124.1 TiMBERLINE 40 X 10124.1 TIMBERUN PRESTIQUE LIFETIME • X 10124.1 TIMBERUfV� UITRA X 10124.1 SLATELINE X 10724.1 OWENS CORNING OAKRID6E PRO 30 X 10674.1 OAKRI E PRO �0 AR ' X 100T4.1 OAKRIC E PRO 40 X 70E74.1 OAKR OOE PRO 40 AR . X 10A74.1 OAKRIDE PRO so x 1oe7a.1 OAKRIOG6 PRO SO AR X 10Q74.1 • OURATION X 10674.1 . DURATIOM PREMIUM X 108T4.1 CLASSIC X 10674.1 CLASSIC AR X 70674.1 SUPREME X 10874,t , SUPREME AR X 10074.1 PROMINENCE X 10874.1 PROMIMENCE AR X 1o8T4.1 9ERKSHIRE X 10874.1 WEATIiER GUARD HP X 10874.1 TAl1AK0 GIA33 SEAL AR X 198B.4 ?, EUTE GLASS SEAL AR X 1958.1 ' NERITAGE 30 X 1986.3 � HERITAGE XL X 1956.5 HERITAOE b0 " X 1956.4 '_ • HERITAl3E VINTAGE AR X ���•� ° IeI�OTICE OF COMIVIENCEMENT STA"Cli OF FLURIDA �, COUNTY OF �a�� THE UND�RSIGNeD hereby gives notice that improveinent will be mada to certain real properiy, and in accordance with Chapter 713, Tlori�a Statues, the following mformation is provided in this Notice of Conunencement: 1 Description of Pro erly: Parcel No. Z.�o � Z"('b Q— — �j 'F�1 r� n u Z ►- 3 et�� �� �,h ���ls Ra l P�- sy �� +�2 � c��s t�� 6loc(< ao�6 �R rT.a�3 AG- o2qb 2. Gene ( Descriptiox► of Lnprove`ment: IIIIII�IIIIIIIIIIIIIIIIIII�IIII�IIIIIIIIIINI�IIIII�INIIIII 2 rDC� �C w C,�`QX 2011062316 3. Owner Tuformation: Nam • � � Addrass: �j V C��' State !i Zip code Interest in Pro rty� Qc�,�1�Q1'� Nama ofFee Sunple Tittleholder: If other than owner: Address: C '�' State Zip Code � Contractor: V\ �p��y ��� ��3 —�'g a ' Address: 36 13 S.R. 5�} Zephyrl�i� F 41 � 5,! Surety: Name N/A Repi:1363970 Rsc: 10.00 I D5: 0.00 IT: 0.00 — Address 04/26/11 q, Gia�d, City State. �PlY Clerk PpULq 5 0'NEIL,Ph � PRSCO CLERK 6 COMPTROLLER � Amount of Bo�id: $ ' � 04/26/ 11 0 1 oF 1 j OR BK o q, P� 2336 G� Lender: Name N/A Phone # '� Address � L ��Y State 'Lip Code 7� Persons within tlie State of Florida designated by owner upon whom notices or otlier documents may Ue served as j provided by Section 713.23 (1) (a) (7), Florida Statutes: � Name �1/A Phone # � Address � City � State Zip Coda $�'� In addition to himself, Owner designdtes: N/.A I °f Phone # to receive a copy of tha Lienor's Notice as provided in section 713.13(1) (b), Florida Statutes. 4: Expiration date of Notice of Cori�mencement (the expiration data is one (1) year from the date of recording uules� a i different date is specified.) � WARNING TO OWNER: ANY PAI�MENTS MADE BY THE OWNER AFT�R THE EXPIRATION OF THE I�OTICE OF CpMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPT�R 713, � FART I, SECTION 713.13, FLORIDA STATUTES, ANll CAN RESULT IN YOUR PAYING TWICE FOR IMPROVE1vIENTS 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 COlVIMENCING WORK OR RECORDING YOURNOTICE OF COMMENCEMENT. Signahire of Owner: � Printed Name--�' Q. STATE OI' FLQ�� A COUNTY OF T'aSCJ Q The foregoing instrument was.aclmowled�ed befora me tliis - day of �Q�: � , 20�, arsonally known to me or who produced identif l4�,�u�rah�8i�t taka oath (please cn•cle which) J4nN a Sr w(7So. �,r*r w� Naer Puene s�re or Floriea Christlan Ryman Notary Pub '. My Commission Expires: _ '�. ""�' co�,�sswn �o�s,eio �prea ovzuzoiz Under penalties of perjury, I declera tliat I have read the foregoing Notice oE,Commencement and d�at tha fnets stated in it are true to th st of my knowl e�and belief. '' /\ (Signature of Owner Signing Abov , t � �,'�qYE a� �'LORIDA, COUNT�(-Q� � � THIa IS T(� C�RTIF'Y ?HA7 THE` ��� NT �C'�; TRUE ANp CORRECT COP _. E DOC[1ME QN FILE OR 0� PUBLIC RE b 7A1,tHIS 4��G� ,', � WITNES� MY HAND A Q.(�1AL :�EA�.t�IfiS' pAY QF � ' � � � O �� S u PAU O'NEIL, CL K�- � � ;5 .-1 /, ..1.._ P � . �� BY .. .� . � ; .t.,; ,