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Home My WebLink About14-15688 _ '" CITY OF ZEPHYRHILLS � 5335-8TH STREET (813)78 -0020 1 5 $ BUI�DIN PERMIT �„��° ��r:K%�:.�.�TP:ERMlT��lNFIORMATION `, LCICATION INFORMATION�: `:'�`:�'�,`�'`� �#��' Permi# Number: 15688 Address: 5749 20TH S 5742 19TH ST Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL. Glass of Work: 434-ADDIALT RESIDENTIAL Township: Range: Boak: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivisian: CITY QF ZEPHYRHl�LS Est. Value: Parcel Number: 11-26-21-0010-07800-0010 Improv. Cost: 200A0 , " ff''��°°QWNER�INFORM�'ATIfJN`a. �"`�.�`��._ � � , � � ��..�:°= Date Issued: 9/26/2014 Name: F&R BLOCK HOMES LLC Total Fees: 80.00 Address: PO BOX 566 Amount Paid: 80.00 ZEPHYRHI��S F�33539-0566 Da#e Paid: 9/26/2014 Phone: Wark Desc: INSTA�L 2 EXTERIOR DOORS a. � _:A�`CONTRA,CTOR S � ° APPLICATION FEES'..�_�_ ° " O ER BUl�DIN EE 40.00 AFTER THE FA T 4 .00 � �'"�,,' j� � �� ' �� ,�f�� , r.- u. y *�,r ..,,� „. , „ _ . v , . �%� -'� �_ ;r� � � • _�; , ,. _ �..-W�.,,� . . ' _ . . � _ . �- � . . °. Ins ection` Re uired �` �`'' . .. � . :�.� .�µy-ti,�.� - � �� FQOTER 2ND ROU PLU B IS !NS � TION EILIN FOOTER BOND DUCTS 1NSULATED EWER MiSC. ROUGH ELECTRIC LINTEL ISG MISC. 1ST ROUGH PLUMB PRE-METER 1 SULATiOiV WAL� lVIISC. DUCTS INSTALLED WATER ISC DRIVEWAY PRE-SLAB SHEATHING ISC. MISC. CONSTRUCTION POLE FRAME ISG. MISC. REINSPECTION FEES: Reinspection fees will camply ith Florida Statute 553.80 (2)(c)when ex#ra inspection trips are necessary due ta any one af the#ollawing r asons: a)wrang address b)condemned work resulting from faulty construction c) repaiws or corrections n t made when inspections called d) wark not ready far inspection when called e) permit not pasted an j b site f) pians not at job site g)work not accessibte. NQTiCE: In addition to the requirements of this permit, the e may be additiona! restrictions appiicable to this property that may 6e found in the public records of this county, and ther may be additional permits required fram other gavernmental entities such as water manageme t, state agencies or federal agencies. "Warning ta owner: Your failure ta record a natice of commencement may result in yaur paying finrice for impravements to your property. If you intend to a tain financing,consult with your lender or an attorney before recording yaur otice of commencement." Complete Plans, Specifcations Mus#Accompany App�lication. All work shall be perFarmed in accordance with City Codes and Ordinance�. N�OCCUPANCY BEfO C.O, s � CO CTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION 8 HOUR NQTICE REQUIRED PROTECT CAR FROM WEATHER I 813-780-0020 City of Zephyrhi'Is Permit Appiication Fax-813-780-0021 Building Department IDate Receieed Phone Gontact f r Permitting -- Owrner's Maone �� /C��L. �,��Y�,S �.L Ouvner�'hone Idumber 7j"��'� �� Owner's�lddress P0;7��(p " �n l 3� �J O�nrner Phone idumber Eee Sicnple Titl�holder Mame O�nrner Phone Mumber Fee Simple Titleholder elddress JOB�1DDRESS Pj�y� I� � LOY# �� SUBDIbISIOM PARCEL 9D� — -- - , - — - �- — — - - (OBTAINED FROAA PROPERTY TNC NOTICE) — -- - � HNOEt6(F'ROPOSED � NEW CoNSTR e ADD/ALI � SIGN Q Q DEMOLISH INSTALL REPAI P�tOPOSED USE r Q SFR Q COMM � OTHER 7YPE OF CONSTRUCTIOfd Q BLOCK Q FRAME 0 STEEL 0 DIESCRLP�IOM OF WORK � � BUILDING 51ZE S(A FOOTAGE HEIGHT OBUILDING $ � �� VALUATIOfV OF TOTAL CONSTRUCTION QELECTRICAL $ AMP SERVI E � PROGRESS ENERGY Q W.R.E.C. QPLUMBING $ QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION OGAS Q ROOFING Q SPECI LTY 0 OTHER FIfVISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO BUILDER C AAPANY SIGIdATEJRE RE ISTERED Y/ N FEE CURRE� Y/N Address License# ELECTFtICIAN C MPAMY SIGMATURE RE ISTERED Y/ IV FEE CURRE� Y/1� aldldress License# PLUM�ER C MPA�lY SIGIdATURE RE ISTERED Y/ IV FEE CURRE� Y/I� e4ddress License# MIECHAIdICAL C IkAPAPdY SIGRIATURE RE ISTERED Y I N FEE CURRE� Y/N Address License# OTFlEPZ C MPAMV SIGfdATURE R GISTERED Y/ N FEE CURRE� Y/N Address License# RESIDE{NTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)se of Energy Forms;R-O-W Permit for new consWction, Minimum ten(10)working days after submittal date. equired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities 8�1 dumpster;Site Work Permit for ubdivisions/large projects COMAAERCIAL Attach(3)complete sets of Building Plans plus a Life afety Page;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)working days after submittal date. equired onsite,Construction Plans,Stormwater Plans w/Sitt Fence installed, Sanitary Facilities&1 dumpster.Site Work Permit for II new projects.Ail commercial requirements must meet compliance SIGfd PERIlAIT Attach(2)sets of Engineered Plans. ""PROPERTY SURVEY required for all NEW cons ction. Direct(ons: Fill out application completely. Owner&Contractor sign back of application,notarized �. If ov�r$2500,a INotice of Commencement is required. (4UC up rades over y7500) ,,.-,w...,..:..�-,-,. _-,,-~�` ;: ,.,..,,F,.�:,.,.>:-4=. -_. Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarize�letter from ovimer•authorizing,same�,••; � a :;`,,.,c :: f::,.c' �•.:':'+ � ` a ONER YHE COUNTER PERINI7"PING (Front of Appl(cation Only) :,; . , . _... � ..- - Reroofsifshingles Sewers Serv(ceUpgrades A/C Fenc s(Plot/Survey/Footage) D y:•:;-�.- °, , ,• '' , ;y v„ ,r �..r.�° �Lx.uc�,w,�:... *c . . �.�, . Driveways-Not over Counter if on public roadways..needs ROW YVOT'I�C� O� H7EEI� R�S�'�IC7"ION�: The undersigned undersiands that this permit may be subject to"deed" restrictians" which may be more restric#ive than Gounty regulations. The undersigned assumes respansibility for compliance vuith any applicable deed restrictians. t9NLlCENSE� CC?h!'TFt��GY�� A�D G�N7'�#i�T�9� f�f�S�4?N�lf��L.Y'Ytf�S: If ths owner has hired a cantractor or confractors ta under#ake work, #hey may be required to be licensed in accordance writh state and iocal regu{ations. !f the contrackor is not licensed as required by law, bath th� o�nrner and contractor may be cited for a misdemeanar violation under sfa#e law. if fhe ownee ar in#snded contractor are uncerfain as #o v�rhaf licensing requirements may apply far th� intended work, they are advised to cantact the Pasco Caunty Building Inspection Division—Licensing Section a#727-847- 8009. Fu�thermare, if the owrner has hired a cont�actar or contractors, he is advised to have the contractor(s) sign partio�s of the "contractor Biock" of this application for which fhey wiil be responsible. if you, as the ovvner sign as the cantractor, that may be an indication that he is nat properly licensed and is not entitled to permitting priY�ileges in 6'asco County T�NSPO�t"fA'�IQP� IAfi�'ACTIIJYILITIE� IfiflP�C1f l�Pl� i�E�OU�� R�COV�RY F��: The undersigned undersfands ( that Transpor#ation Impact F�es and Recourse Recovery �ees may apgly to the construction af nevtir buildings, change of use in existing buildings, or expansion of existing buildings, as specified in Pasco Caunty Ordinance number 89-07 and 9Q-Q7, as amend�d. The undersigned also understands, that such fees, as may be due, wil! be identified at the time of ' permitting. lt is further understood thaf Transportation (mpact Fees and Resource Recovery Fees must be paid prior fo receiving a "certificate of occupancy" or final pov�er release. If the project does not involve a certificate �f occupancy or final power release, the fees must be paid prior to permif issuance. �urthermore, if Pasco County WaterlSewer Impacf fees are due, they must be paid prior to perrnit issuance in accordance with applicable F'asca County ordinances. ��N��'�t]GT��}M �.�lE� �.�lfitt(�F��f��7�3, �Ic��oef��t��ut��, �� t�e�d+�c9}: If valuation of wrork is$2,500.00 or more, ! certify #hat I, the applicant, have been provided with a copy of the "Florida Constructian Lien Law—Homeowrner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If ths applicant is sameone other fhan the"owner", 1 certify that 1 hav�obtained a copy of#he above described document and promise in good faifh to deliver it to the "ovuner" prior to commencement. C�Nl'R�GTt3R'S101iV�9i�R'�I�iiF�l�}t�11[1': ! certify that alE the information in this application is accurate and that all work �vill be done in compliance with all applicable lawrs regulating construction, zoning and land dev�lopment. Applica#ian is hereby made to obtain a permit to do worlc and instaflation as indicated. 1 certify that no wor4c ar instaNation has commenced prior to issuance of a permit and that all work �ill be performed to meef standards of all laws regufating construction, County and Ciky codes, zoning regulations, and land dev�lopment regulations in the jurisdiction. I also certify that t undersfand thaf the regulations af ofher govarnment agencies may apply ta the intertded rn�ork, and that it is my responsibility to iden�'tfy what actions I must take to be in campliance. Such agencies include but are not limited to: - Departmen# of Enviranmenfal Protectior�-Gypress Bayheads, Wettand Areas and Environmentally Sensitive l..ands, WaterNVastewater Trea#ment. - Sauthvuest �iorida ltVat�r Management District-1tVells, Cypress �ayheads, V�(etland Areas, Altering Watercourses. - Army Corps of Engineers-Seauvalls, Docks, Navigable Waterways. - C7epartment of Health � Rehabilifative ServicesJEnvironmental Nealth Unit-WelEs, 'UVastewater Treatment, Septic Tanks. - US Environmental Protectiort Agency-Ashestos abatem�nt. - Federal Aviation Authority-Ftunways. I understand that the foflawing resttictions apply to the use of fill:� - Use of fill is not allowed in F1ood Zone"V"unless expressly permitted. - If the �Il material is to be used in Flood Zone "A", it is understooci that a drainage plan addressing a "compensating volume" vuitl be submit#ed at time of permittirtg vuhich is prepared by a professional engineer licensed by the State of Florida. - If the fill material is ta be used 'tn Flood Zone "A° in connectEon uvith a permitted building usRng stem �nrall construction, I certify thak fill will be used only to fill the area within the sfem wali. - If fill material is to be used in any area, 1 certify that use o# such fill will not adversely affect adjacent proper#ies. If use of fill is found to adversely affect adjacent properties, the owner may be cifed far violating the conditions of the building permi# issued under the attached permit applicatian, far lots less than one (1) acre which are elevatecf by fill, an engineered drainage plan is required. If I am the�,GIEIVT �OF21fFVL Olf��lEl�, I promise in goad faith to inform the owner of the permitting conditions set forth in this affidavit prior fo cammencing constructRan. 1 understand that a separate perrnit may be required for electricaE work, plumbing, signs, wells, pools, air condifioning, gas, or ofher installations not specifically included in t�e appiicafion. A permit issued sha!! be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisians of tha technical cades, nar shall issuance of a permit preven##he �uilding O�cial from the�eafter requiring a correction of errors in plans, construction or violations of any cades. Every permit issued shall become invalid unless #he work authorized by such permit is camrnenced w�ithin six manths of permit Essuance, or if uvork aufhorized by khe permit is suspended ar abandoned for a periad 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 nak #o exceed ninety (90) days and wi!! demonstrate justifiab(e cause far#he �xfension. It work ceases fior ninefy t90)consecutive ciays, fhe job is considered abandaned. �ARtd9Fd� "f0 Qi�IN��: ��t3� i�6�1�17�� T� ��Ct3�� 9�TpC�C U�F �:�ii��PlC��d�i�Y ��l' ��E sUi..'T 1i�1 'Y�}U� �'WYING TV11iCfE �'CDR If�i�'�tOV�I1N�Gd7S �'KJ YOl9� �'V�C16'E�tYY. I�YOU YN1YENfD T�D 0�7WIN FINA�ICIPIfs°, C��I�l1�Y Vitt7H Y{}lJl� L�NC}IE��?I�d��1 Al�t'QIRi�1EY��I��COi�fD1�1G Y�tJR�IOTIG�C?F CO�II�EP1C��ti�W1�. FLORIDA JURAT(F.S. 117.03 C11flt�tCf2 Ogt�G�TdT • CORITE�AGTOFt Subscribed and sworn or med efore me this Subscribed and sworn to(or affirmed)before me this by by Who isJare personally known to me oe haslhave produced Who;slare personally known ta me or haslhave produced as Identification. as identificaGon. •.Y��r . j �mssio�13707�Nota Public Notary Publia r�°�:Ilf�t;a�`�'�� amawnwr�fl8 ,2(}'18 Com iss n `°'"F""1°'�°^Geooaes�o�o Commission P�lo. Name of Notary typed,printed or stamped IVame of Notary typed,printed or stamped ( , t 813-780-0020 City of Zephyrh Ils Permit Application Fax-813-780-0021 Buildi g Department Date Received Phone Contact f r Permittin __ O�nrner's fdame .�� O�V�- S �� Oarner Phone Mumber U��7��S�O /��, 1 Owner's Address � `[i�Y� ,�� Owner Phone�dumber Fee Simple Titleholder Mame Owrner Phone tdumber Fee Simpie Titleholder Address � JOB ADDRESS S � � ' ��` LOT# �� SUBDINISIOM � PARCE ID# - _--.--. - - -_-,- •-._-- -- �__.`___ _ _ -� - (OBTAINED FROM PROPERTY TAX NOTICE) -- --- ---- ---- - NHOR�C PEtOPOSED � NSTALLSTR B REPAIR � SIGN Q Q DEMOLISH ,LJ �ROPOSED U�E t � SFR Q COMM � OTHER IYP�OF CONSTRUCTIOtd Q BLOCK Q FRAME 0 STEEL Q DESCRIPTIOfd OF!lUORK � L��,S BIiILDIfdG SIZE SQ FOOTAGE FIEIGHT OBUILDING $ �� VALUATION OF TOTAL CO(VSTRUCTION QELECTRICAL $ AMP SERVI E 0 PROGRESS ENERGY 0 W.R.E.0 QPLUMBING $ OMECHANICAL $ VALUATION OF MECHANICAL IIJSTALLATION OGAS Q ROOFING Q SPECI LTY 0 OTHER FIfVISHED FLOOR ELEVATIONS FLOOD ZONE AfiEA QYES NO BUILDER CO PAtdY ��'� \�.� b1�.S SIGMATURE RE ISTERED Y/ N FEE CURRE� Y/N Address License# ELECTRICIAM COiflAPAfVY SIGfdATURE RE ISTERED Y/ IV FEE CURRE� Y/N c4ddress License# PLUMIBER C MIPAtdY SIGIdATURE RE ISTERED Y/ N FEE CURRE� Y I(V 4lddress L(cense# MIECHAIdICAL C MPAfdY SICzPVAT�DRE RE ISTERED Y/ N FEE CURRE� Y/N Address License# OYHER C iUPAMY SIGMATURE RE ISTERED Y/ RI FEE CURRE� Y I N Address License# RESIDEMTIAL 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. equired onsite,Construction Plans,Stormwater Plans w/Silt Fence instailed, Sanitary Facllities 8�1 dumpster;Site Work Permit for ubdivisions/large projects CONIIlAERCIAL Attach(3)complete sets of Building Plans plus a Life afety Page;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)working days after submittal date. equired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster.Site Work Permit for II new projects.All commercial requirements must meet compliance SIGM PERMIT Attach(2)sets of Engineered Plans. '•••PROPERTY SURVEY required for all NEW cons ction. Directions: Fill out application completely. Ovmer&Contractor sign back of application,nota�ized If over 3a500,a Rlotice of Commencement(s required. (A/C upg ades over�7500) '" Agent(for the contractor)or Power of Attomey(for the owner)would e someone with notarized letter•from owner authorizing same=•='"'".`' OVER THE COUNTER PERMITTING (Front of Appiication Only) � � _ ' , ,. i: Reroofs if shingies Sewers Service Upgrades A/C Fence (Plot/Survey/Footage) , . ' � � - ,. ; '= -• � � ...,, �.>.. �riveways-Not over Counter if on public roadways..needs ROW _.: ., � " N�TIC� OF B�EEH7 P2E��'�IC7"ION�: The undersigned understands that this permit may be subject to"deed" restrictions" r�thich may be mo�e restrictive#han County regulations. The undersigned assumes responsibility far compliance with any applicable deed restrictions. Y�N�ICiEtd�ED CONT��TO�d� �R4l� CQN�'��'�f� f�{��IPQPYS�I�fl.�Ylf��: ff fhe ouvner has hired a contractor or I contractors fo undertake �ork, they may be required to be licensed in accordance with state and locai regulations. if the ' contractor is not licensed as required by law, bath the owner and contractor may be cited for a misdemeanor violation under state Iawr. if the av+rner or in#ended cantracfor are uncertain as to �hat licec�sing requirements rr�ay apply far the intended work, they are advised to cantact the Pasco Caunty Building Inspection Division—Licensing Sec#ion at 727-847- 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractar�s) sign partions of the "contractor Blocic" of this applicatian for which fhey vvill be responsible. If yau, as the avvner sign as the contractor, that may be an indication that he is not properly licensed and is not entitled to permit#ing privileges in Pasco County. T�PD�PORT"ATIi7N I�fI��CY1lY�IL9TIE� Yfl�l��°l�R1C1 �E�1Dfl�� tf��0i/�RY ��: 'The untlersigned understands that Transpartatian tmpact Fses and Ftecourse Recavety Fees may apply to the cansfruction of new buildings, change of � use in existing buildings, or expansian of existing buildings, as specified in Pasco Caunty Ordinance number 89-07 and 90-07, as amended. The cie�dersigned aiso understands, that such fees, as may be due, wilE be identified at the titne of , permitting. It is further understood that Transportation Impacf Fees and Resource Recovery Fee� must be paid prior to , receiv4ng a "certificate of occupancy'" ar fina! power release. (f the project does not involve a certificate �+f occupancy or finai porn�er re(ease, the fees must be paid prior ta permif issuance. Furthermare, if Pasca County WaterlSewter Impact fees are due, they must be paid prior to permit issuance in accardance with applicable Pasca County ordinances. �ONSTRUCl'1��f �.IIEN 1.��ha��r��9�, i�lar�d�St�futes, �s am�nd�e!}: !f valuation of work is$2,500.00 or more, 9 certify 4hat I, the applicant, have been provided with a capy of the "Florida Constructian Lien Law—Hameowner's Protectian Guide" prepared by the Florida Department of Agriculture and Consumer Flffairs. If the applicant is someon� ather than the "owner", 1 certify that t have obtained a copy of the abave described document and promise in good faith to deliver it to khe"owner"prior to commencement. ��N'�R�CT��t'S/t21fi��1��'� �►��kli/I�': I ce�tify that a11 the information in this application is accurafe and that al}�trork �nrill be done in compliance with all applicable laws regulating consQruction, zoning and land development. Application is hereby made ta obtain a permit ta da uvork and installation as indicated. 1 cerfify 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 Ciky codes, zoning regulations, and land developrnent regulations in the jurisdictian_ ! also certify that 1 unders#and thaf the regulations of other govePnment agencies may apply to fhe infended vvark, and that it is my responsibility ta identify what actions I must take to be in compliance. Such agencies include bu#are not limited to: - Department of Environmer�tal Protectian-Gypress Bayheads, 1��tland Areas and Enviran�rtentally Sensitive Lands, WateNWastewater Treatment. - Southv�rest Florida Water tt�anagement District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. , - Army Corps of Engineers-Seawalls, Docks, YVavigable Waterways. - Deparfinent af Heaith � F��habilitative Services/Environmental Health Unit-Wells, Wastewafer Treatment, � Septic`fanks. � - US Environmental Pratection Agency-Asbestos abatement. � Federal Aviation Authority-Runways. � t understand fhat#he fa!lowring restrictions apply#a the use of fill:� - Use of fill is not allowed in Fload Zone"V"unless expressly permitted. - If the fill material is to be used in Flood Zone "!1", it is understood that a drainage plan addressing a "compensafing volume" vtriil be submitted a# time af permifting �nrhich is prepared by a professiona) engineer licensed by the State of Florida. - If the �11 material is to be used in Flood Zone "A" ir� connectioe� writh a permi#ted building usi�g stem v+ra}! construction, I certify tha#fill will be used only to fill tF�e area within the stem wall. � - tf fiN material is to be used in any area, I certify #hat use of such fil! uvill not adversely affect adjacent ' properties. �f use of fill is found to adverseiy affect adjacent properties, the owner may be cited for vioia4ing ihe conditions of the building permi# issued under the attached permit applicatian, for Iots less than one (1) acre which are elevated by fill, an engirt�ered drainage plan is required. If I am the AGENT FOR 7F6� SJIYVN�1�, I promise in good fai#h to inform the owner of the permitting conditions set forth in this atfidavi# priar ta cammencirtg canstrttction. I understand that a separa#e permit may be requiced for electt'ica! work, plumbing, signs, wells, pools, air conditioning, gas, or ather installations not specifically included in the application. A permit issued shal! be construed to be a license �a proceed vuith the v�rork and not as authority to.violate, cancel, a!#er, or set aside any provisions of fhe#echnical cades, nor shal) issuanc�af a perm'tt prevent the Building Officiai from thereaffer requiring a correctian of errors in plans, construction or violatians of any codes. Every permi# issued shall become invalid eanless the work authorized by such permit is commenced within six rnonths af perm9t issuance, ar if work au#horized by the permit is suspended or abandoned for a period of six(6) months after#he time the work is commenced. Nn extension may be reques#ed, in v+rriting, from the 8uilding C7fficial for a period nat #o exceed ninety (90) days and wril! demc�nstrate justifiable cause for the extension. If work c�ases for ninety(90)consecutive days, fhe job is considered abandaned. i�f.�Rtd9�1� TO OWPI��: lf��.,l�t 1F�11L�R� �O ��C�D�D ,� W��IC�E O� C��II�itEN�E�iI��IT i�iAY RIE�t9LT 1}� 1(C24�� 'f�YINt�'�VIIICE�CI� IY1��ROV�nfiE��'� 7�J YOt9�t �'fFtO��R'�. i�1�OU IRITEND TO 0�7,�iIN FIIJA�VCIFIC, COiV�U�.Y V�IYH Y�l��L�NC?��t Q��➢ {3�2��Y(��(F�(F�i��if2lD1G�lC9 Y�U��JOT1C�O��lif�i�l�[dGE#it��WY_ FLORIDA JURAT(F.S. 117.03) O{flt�VEi2 4�AG��1T J �Oftl'T�CTCt� 5ubscribed and swom to(or affirmed)before me this Subscribed and sworn to(or affirmed)before me this by. . by Wha istare person know to me ar haslhave produced Who islare personally knavvn to me or haslhave produced as Ide tificatian. as identification. S �� T� �'"� '� �� Public Notary Public Commisslo �'�t�,*�' :�� Ex�m�ss+��#��`'d3i�47w3 Commission No. eondadrhtu:`F�i�?a��cx�_•u��p.�. ,�„ Name ot Notary'.�typetl,�printed ar stamped r,� 't Name of Notary typed,printed or stamped