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Home My WebLink About14-15700 r CITY OF ZE HYRHILLS 5335-$ STREET , , �si�)�s -oozo 15 0 BUILDIN PERMIT �;��.• P.ERM{7'�IN�ORNIATION . � ' ' '� ��"h& � ��'��LOCATION�INE�O:RIVIATIC'>(V`��,�'�`��" Permit Number: 15700 Address: 585� 13TH STREET Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL. Class o#Work: 434-ADD/ALT RESIDENTIAL Township: Range: Baok: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: 5quare Feet: ` 5ubdivision: G1TY OF ZEPHYRHl�LS Est. Value: Parcel Number: 11-26-21-0010-03900-0110 Improv. Cast: 18 Q00.40 �s -'��"`;fi '�� `- `� - � ..�� t'�iV1►NER�INFORMATl�ya.IV,:r ::� Date Issued: 10103/2014 J Name: SERVIES MiCHAEL & SHERAE Total Fees: 367.50 Address: 5850 13TH ST Amount Paid: 367.50 ZEPHYRHI�LS F� 33542-3757 Date Paid: 10/03/2014 Phane: (813)403-3825 Wark Desc: 960 SQFT ADDETIt�N & CQNCRETE LAB 28'X 40' ` ��;��;CONTRAC.TOR S � APPL:3ICATION:FEES�,�= �,�;"'"�. �M;�:�`_: O EOW ER BUILDING�EE 187.50 CTR AL FE 60.00 HOMEOWNER PLUMBtNG FEE 60.00 MECHANICAL FEE 64.d0 HOMEOWNER NQME4WNER V ,,..--- S I� �G� � � �� ..� �� i � � -�f� - � ,. � .M� _ ,. �,, , �.... :. .Tb„r_ � :3 . ��,�, � ° ` �=- � =~�� r.., ��.�° =.x� :�.;,�,� Ins...ectiiiri �Re ui�ed°.a�- ,. �K..� �,°�."�:��,��, �.° F TER 2ND E20UG PLUM ISC ihlS � O CEILIN FOQTER BOND DUGTS INSULATED EWER MISC. RpUGH ELECTRIC LINTEL ISC MISC. 1ST ROUGH PLUNIB PRE-METER 1 SU�ATION WAL� M1SC. DUCTS INSTALLED WATER ISC DRIVEWAY PRE-SLAB SHEATHING ISC. M1SC. CONSTRUCTI4N POLE FRAME 15C. M1SC. REINSPECTION FEES: Reinspection fees will comply ith Florida Statute 553.80 (2)(c)when entra.inspection trips are necessary due ta any one of the fallawing re sons.a�wrang address b}condemned work resulting from faulty construction c) repairs or corrections no made when inspections called d)work nat ready for inspectian when calted e) permit not posted on jo site f} plans not at job site g)work not accessibte. NQTKE: In addition to the requirements of this permit, ther may be additional restrictians applicable to this properry that may be found in tha public records of this county, and ther may be additional permits required from other governmentaf entities such as water manageme , state agencies or federal agencies. "Warning ta awner: Your failure ta recorci a natice f commencement may result in your paying twice for improvements ta your property. If you intend to ob in financing,consult with your lender or an attorney befare recarding yaar tice af cammencement." Gomplete Plans,Specifications Must Accompany Appl cation. All work shall be pertormed in accordance with City Codes and Ordinances. NO OCCUPANCY BEPO C.O. CO TO SIGNATURE PERMIT OFFI R PERMIT EXRIRES IN 6 MONTHS ITHOUT APPROVED INSPECTION CALL FOR INSPECTION - HOUR NOTICE REQUIRED PROTECT CAR FROM WEATHER � • 5•"�d ^��x} Y � ��r �► [�� n5t�r Load Calcu9ati� n � ��'� Results are intend�d for usew th Rheem heating and cooling s sterns --, Y ,�„ ..�,��i��,�;�,.,, ,•z ..;,,�;.,.�• I • � . ! Street Adciress 5850 13th St.,�Zephyrfiilis, FL 33542 Latitude, Longitude 27.9961°, -8 .58Z° � House Squ�re Footage: 1'850 sq. ft.' ' Nan��e: Milce 5ervies Pf�one: 813-782-3739 ' �i7»ii: � ! °' � . ! SH P� .�5 Nurt�ber �f rF�icl�nfis 5 Ceiling I�ciglit: g .. ......... ........... _. ._. ._.___.._. ._. ._. ._... _..__. ...--..--..-----._-----._. _.._..__.._..__. _. ._. .--. .-.--.- .- � Wall U-value � (�-value 0.09 � 11 r — Floor U-valu� � R-value U.2 � 5 Ceiling U-value � R-value 0.053 � 19 � Wind��rra lJ-val�.ie � 1Nir�i�lcw SHGF p.�5 Moi�;tt }�P g�-�ins 56 Duct loss `% 10 .--.._. Duct �ain % �p . Coolin� infiltraction (AGH} 0.6 f-leatin� infiltration (nCf-I) O.B Winter ventilation p S�immer ventilation p � - • • s • Outdoor Heating Cooling Dry bulb (°F) 0 - 96 Daily range M Relative humidiry 50% Moisture diffei�ence 56 I ndoor Heating Cooling Indoor temperature (°F} 70 74 - - - - - - - Design temperaturr� difference(°F) 30 i1 .. ._. ._. _ _. .. � s • A s s Area �tuh % of load Wall 3463 12.7 � Floor 3612 13.2 Ceiling 2942 10.8 WincJows 7980 29.2 , Infiltration 6813 25 , System Efficiency Loss 2481 9.1 Total: 272gp Heating Loads ��,�90 sruirn- �System Efficiency Lass �'� �'1'^�:P Windows � �;,�;ry-�, � �Ceiling ;`j�;,;��• �'y ',i {.i_ �� ,`��3;�t�i�,. � Wall - I `Floor Infiltration � � � - ! � . • A . • � o , � Area Btuh /o of load , . ... ... ........ .. ... , ._. W�II Z539 6.1 Ceiling 46G)S lI , Windows 16856 40.4 Sei�sit�IP Irttiltration 3747 � � Latent Infiltration 5896 14.1 � � Syslem Ef:fici�ney G:�iii 336� 8.� Internal 2400 5.8 , _ _ �Pn�il�1l�� f'ec�p.le �.oa��1 _ 1150 � �2.8 ` -; - , �, Lat�nl People Load 1150 2.8 � ' Tc�i:al; ' �177 3 � 5ensible load 3�6fi6 . Latent load 7046 SHK 0,�33 Capacity at .75 SHR 3.85 Tons Cooling Loads , �.1,713 BTU/hr r Sensible People Load I �Latent People Load Internal i`;;��;;'�/�Wall '��i�f�'.�;.#�. r�w ' n. Wifl(IOWS� �,;t��-� "'�°_' tr5t ��> l System Ef icienc . r;�' � �Sensible I filtratio i � `Ceiling Latent Infiltration A � " � . - A • ' � ' --------- ----------�------------------------------------ AED G aph � z0000 - � is000 - . � I i p 10000 j i , 5000 � � I � 0 I 8am 9am l0am llam 12pm lpm 2pm 3pm 4pm Spm 6pm 7pm 8pm � � — Hourly Loads —Average � I ----- - ------� , --- - - --- - - - - -- - --- - -- -------- -- - - ------ I � � ° w .� � System equipinent selection will be made using the following deri ed values. Glass (E) 134 sq, ft. Glass (S) 19 sq, ft. G' Giass (�I) 19 sq. ft. Glass (VI/) 94 sq. ft. Sui�mer Outdoor g6°F i Summer Wet Buib 77°F Summer Indoor 74°F � Si.ii�ir��er Desic�n Grains 50% IA/inter pui�door 40°F Wir�ler� Incaooi� 7Q°F Sensible Coolinc� 34,G66 Btuh Latei�t Coolii�g 7,046 Btuh Required Cooling /�irflow 7_,57.6 CFM �-- - �---�--- - Sensible Heating 27,290 Btuh Requirecl He�ting /�irfiow ;54 CFM � All cakulations are based upon approved hvac industry standard and procedures,and comply with all local, state and federal code require�7ients.All corriputed resulCs are Es imates Product provided k�y Eneryy Desiyn Systems and Idea Tree � IIl!lllllllllllllllllilllll!(!llllll(Illllllllllllllllllllll 2014155329 Rcpf.:1632852 Rec: 10.00 NOTICE OF C MMENCEMENT DS: 0.00 I T: 0.00 PermitNo. 10l01/14 E. Munguia, Dpty Clerk Property Identification No. — — E�U 3 rlOD- �L l� THE tJNDERSIGNED hereby gives notice that Smprovements wil be rnade to certain real property,and in accordance with Sectian 713.13 of the Flazida Statutes,the following information is pravid d in the NOTICE OF C4MMENCEMENT. 1. Description of property(le,gal descrtption:) a) Street Address: S r 2, General description of improvements � . Owner Information ,.-- a) Name and address: �� S �✓�� S ' 'f" -s''i�'"` b� Name and address of fe�simple titleholder(if other than wner) �'q�� 3 35��2 c} Interest in prflperty ' r� 4. Contractor Tnformatian a) Name and address: --S'a.r+� � Q �^-' r'" b) fielephone No.: � '�- t➢ '' Fax No.(Opt.} 5. Surety Information a) Name and address: b) Amount ofBond: c) Telephone No.: Fax No.(Opt.) 6. Lender a) Name and address: 7, identity of person within the 3tate af Florida designated by o er upon whom notices ar other documents may be served; a) Name and address: b) Teieghane No.: Faac No.{Opt.) 8. In addition to himself,owner designates the following person o receive a aopy af the Lienor's Notice as provided in Section 713.13(1}(b),Florida Statutes: a} Name and address: b) Telephone No.: Fax Na.(Opt.) 4. Expiratian date of Notice of Commencemeni{the expixatzon te is one year fram ihe date of recording unless a different date is specified): WA RNING TU UWNER:ANY PAYMENTS MADE BY T Qt'VN�R AFTER fiflE EXPIRATION OF THE NQTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PA NTS UNDER CHAP'TER 713,PART 1,SECTION 713.13, FLQRIDA STATU'FES AND CAN RESULT llV YOUR PA G TWICE FOR YPROVEMENTS TU YOUR PROPERTX.A NOTICE OF Ct7MMENCEMENT MUST BE RECORDED D POSTED ON THE JOB SiTE BEFURE THE FIRST INSPECTION.IF YOU INTEND Td OBTAIN FINANCING,CONSULT YOUtt LENDER OR AN ATTORNEY BEFORE CUMMENCIlYG WORK OR RECORDING YQU NOTICE F CUMMIENCEMENT. STATE OF FLORIDA �" � �""--- COUN'FY OF PASCO , � i ture OF Owner or OwnCr's Authonzed 4 cerlDzzcctorJPartaerlM�ager r , ,.S ✓'✓ t ' Name The foregoing insuument was acknawledged before me this,�day o ��i�� ,20 T' by /C.{'+L�� Y✓��'.Cv � � � as {type of authori#y,e.g.officer,trust�,attomey in fact)for (na.me of p on behalf of ho instrument was execut PersonalIy Known�QR Produced Identification,.,_ No cy Signatute .t��,•Q. �^.� � . Type of Identification Produoed f"U u�S ��`�'`�'� N e(print) � l �e- 0 ''� Verification pursuant to Section 92.525,Florida Statutes.Under penalties f perjury,I declaze that I have read the foregoing and that the facts stated in it are true to the best of my knowledge aztd belief. � _ FORMS/NOC.rvsd2007 , � SiBu ofN¢nualPersonSigninQAbove �rrr�r •''�r°`., ,lAGQI?EIlNE BOGES ppULA S.0'TIEIL,Ph.D PASCO CL K & CflCIPTROL[.ER �� `� �mmissian#EE040520 10/01/14 10:39am 1 f 1 � ,; �p;re;p�cember 12,2014 �� 8� �� {�G �� '�' � '�'�i$;j�p.°,.F' 8aide�fiuTnrlfan6mratwee0a38S7019 STAT�QF FLC�RlDA,COU6�TY OF PASCO �� THIS IS TG CcRTIFY TNAT THE FOREGOING IS A � �, - � r �y TRUE AND CORRECT COPY OF THE DOCUMENT G ON FILE OR OF PUBLIC REC�RD IN THIS OFFICE ��, p �► �WIT �Y HAND A OFFICIAL SEAL THIS . . ,,.� ; � DAY OF 2�� InGocfli'e�rrust o PAULA S.,O EIL, C ERK&COMPTROLL R �;",�''� � � � B�, �.: . ,� DEPUTY CLERK � 18�� •� �p'��AF F�-��A� � � � \ � / �/ C��`k�, `�� C �• ��1 1 _,� !Er"' �1 L� ' �� I � City of Ze hyrhills BUILDING PLAN RE IEW COMMENTS , ^ . Contractor/Homeowner: ��1 �Y V G�S Date Received: ` ��l `l Site: �� Permit Type: /'�l/«-�� '7 �O s � �?C�d S'l� Approved w/no comments:❑ Approved w/the below omments: Denied w/the below comments: ❑ ? ^ '` � i�t,��. I � � � � �(� .S� G �e �� 3 �111� �� ° ' d� � � , �. ,� � c �f � � cv v " � ! �'�(.,� i S��9/� �,� - �� This comment�Sheet s 11 e kept with the permit and/or lans. ��"—�—/ ' �2 �e-�c' �-� �r��r�' Kalvin wi — 1 s Examiner Date Contractor and/or H meowner % (Required when comments are present) � �' S�� ,��,�,� ;� � 813-780-0020 City of Zephyr ills Permit Application Fax-813-780-0021 Build ng Department � �ate Receieed� Phone Contact oP Permitting � __ c3��j`� O�rner's Idame �� Oarner�'hone Rluenber Owner's Address �ner 6'hone Mumber Fee Simple Titleholder tdarne Ovvner Phone idumber Fee Simple Titleholder Address JOB ADDRESS s LO'T# �� SUBDIbISIOM PARC L ID� (OBTAIPIED FROhA PROPERTY TAX tdOTICE) WORE(P6tOPO�ED � nIEW CoNSTR e ADD/A T � SIGN Q � DEMOLISH INSTALL REPAI �ROP05EI�USE Q SFR Q COMM 0 OTHER F1fPE OF COfdSTitUCTlOfd Q BLOCK Q FRAM 0 STEEL Q D�SCEtI�TIOfd OF HNORK � S D 19l➢ILDI(dG SIZE � SQ FOOT4IGE HEIGHT �BUILDING $ :�� o VALUATIO OF TOTAL COPVSTRUCTION QELECTRICAL $ AMP SERVI E � PROGRESS EPIERGY � W.R.E.0 OPLUMBING $ � ` ,/l� N�� OMECHANICAL $ VALUATIO OF MECHAIJICAL INSTALLATION �.S-� / �"'�"� . a �.��o �GAS Q ROOFING Q SPECI LTY 0 OTHER �� FINISHED FLOOR ELEVATIONS FLOO ZONE AREA QYES NO (�l BUILD�R i / ��C P/oMY � �v� ,9�/�J��' SIGfd?\TURE � RE ISTERED Y/ N FEE CURRE� Y/f�l e4ddress License# �� IELECTI�ICIAfd � �� C IlAPARlY �%/. � d ��\ SIGidA7'URE RE ISTERED Y/ IV FEE CURRE� Y/N �.ddress License# ��u�e�R ��c nnPA�v �-�_ ��,t/��"-' SIGidATURE - Re ISTERED Y/ N FEE CURRE� Y/(V �lddress � License# RAECHANICAL / ' -- � C MPAIdY (�`o� � ��f�� d� SIGfdA�'URE RE ISTERED Y/ N FEE CURRE� Y/N �►ddress License# OTHER C MPAtdY SIGMATI.ORE -R_GISTERED Y/ N FEE CURRE� Y I N ,Address License# RESIDERITIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)se of Energy Forms;R-O-W Permit for new construction, Minimum ten(10)worfcing days after submittal date. equired onsite, Construction Plans,Stormwater Plans w/Silt Fence instailed, I Sanitary Facllities 8 1 dumpster;Site Work Permit for ubdivisions/large projects COAARAERCIAL 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/Siit Fence installed, Sanitary Facilities&1 dumpster.Site Work Permft for II new projects.All commercial requirements must meet compliance SIGR1 PERMIT Attach(2)sets of Engineered Plans. '°'•PROPERTY SURVEY required for all NEW constr c8on. Direc4tons: Fill out application completely. Owner&Contractor sign back of application,notarized If over 52500,a(dotice of Commencement(s required. (AIC up rades over�7500) •' Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same ONER THE COUNTEEt PERMITYING-.- - (Front of Application"Only) , , . ' � � . ', Reroofs if shingles Sewers �� Service Opgrades NC- Fence (PIot/Survey/Footage) �� ; DPiveways-Not over Countec if on putilic roadways..needs ROW -- _• -- . , �_ _ � fN0'�'IC� O� �I��f� R�S"T�iC�'IOPI�: The undersigned understands that this permit may be subject to"deed" re:,trictior�.s" which may be more restrEctive than County regulations. The undersigned assumes responsibifity for campliance with any applicable deed restricfions. U�iL.IC�N�iED CC?IdT�f��1f�F�� PJ� G�PI�'��'�� S�Ot�SGl�IL.17l��: if the owner has hired a contrac#or ar contractors to undertake uvork, they may be required to be licensed in accordance writh sfate and iocal regula�ians. If the contractor is not licensed as requir�d by law, bath the ovuner and contractor may be cited for a misdemeanor violation under state lavv. !f the owner or in#�nded contracfar are uncertain as ta r�vhat licensing requir�ments may apply for the in9ended work, they are a�dvised to confacf the I'asco County Building Inspection Division—Licensing Section at 727-847- 80Q9. FurEhermore, if the owner has hired a contractor ar confractors, he is advised 4o have the contractor�s} sign portions of the "contractar Block" of this application for�nrhich they will be responsible. tf you, a� the o�vner sign as the conkractor, khat may be an indication that he is not properly licensed and is not �ntitled to permitting privileges in Pasco County. 'Y�fV�F�O��'ATIOPI Infl�ACY/l1TBLl�"OfE� 9flii��►C1'�� f��S�1U�t�� R��Oi/f�F�Y FE��: T'he undersigned understands thaf Transportation tmp�ct Fees and Recourse Recavery Fess may appiy to the construction af new buildings, change af use in existing buildings, or expansion of existing buildings, as specified in Pasco Caunty Ordinance number 89-07 and 9Q-07, as amended. The undersigned a(so unders�ands, tha� such fees, as may be due, �rill be iden4ified at the time of permitting. It is fur#her unders#ood thaf Transportation Impact Fees and Reso�rce Recovery Fees musf be paid priar to receiving a "certificate of occupancy" or final pov+rer release. !f the p�ojec# does not involve a certificate of occupancy or finai po�rver release, fhe fees mttst be paid prior #a permit issuance. �urthermore, if Pasca County WaterlSetnrer lmpact fees are due, they rnust be paid prior to permit issuance in accardance v�rith applicable Pasco Coun#y ordinances. C�N�7�l�C`1"ION �.l�i� 1..Atfit(Cha��e�7'13, �1��6d��t�t��, �s ��tn�e�e0e�): lf valuation af uvork is $2,500.00 or mare, 1 ' certify that I, the applicant, have been provided with a capy of the "Florida Constructian Lien Law—Hameo�rner's Prateckian Guide" prepared by the Florida Departmen# of P�griculture and Consumer Affairs. If the applicant is someone other than the "owner", I certify that i have obtainad a copy of the above described document and promise in good fai#h to deliver it to the "owner"prior to commencement. C�}tdT'�t�C70�t'Slt3�V�1�R'S�i�F1�d�V1�': I certif}r that all #he information in �his apptication is accurate and that all work �rvill be done in compliance with all applicable laws regulating construction, zoning and land development. Application is hereby made to obtain a permit to da wrarlc and installatior� as ind'tcated. 1 certify that �o work ar instaltation has commenced prior #o issuance of a permif and th�t all work vuill be performed to meet s@andards of alI laws regulating construction, Counky and City codes, zoning regulations, and land development regulatians in the jurisdictian. ! also cer#ify that I understand thaf the regulations of ofher gavernrnent agencies may apply ta the intended uvork, and fhat it is riny responsibility to identify what actians I must take to be in compliance. Such agencies include but are not limited to: - Departrt�ent of Environmental Protecfion-Cypress Bayheads, 1l�etland Areas and �nviranmen#aily Sensifive Lands, WaterNVas#ewrater Treatment. - Sauthwest Florida Vlfater �Vlanagement District-V1(eEls, Cypr�ss �ayheads, Wetland Areas, Altering Vifatercaurses. - Army Corps of Engineers-Seawalls, l7ocks, Navigable Waterways. - C7epartment of Fieaith � �tehabilitative S�rvices/�nvironmen�aM H�alth Unit-Wetis, Wastewater Treatm�nt, 5eptic l"anks. � - US Environmen#ai Profectior�Agency-Asbestos abafi�ment. - Federal Aviation Authority-Runways. - - t understand that the following restric4fons apply ta the use of fi!!:� � - Use of fill is not a1lo�ved in Flood Zone"V" unless expressly permitted. - If the fill material is to be used in Flood Zone "A", ifi is understaod that a drainage plan addressing a "compensating volume" wiil be submitted a# time of permifting usrhich-is prepared by a professional engineer licensed by#he State of Florida. - � - If the ftll ma#erial is to be used in Flood Zone "A" in connectio� vtri#h a permi#ted building using stem wall construction, I certify thak fill will be used only to fill the area within the stem wall. - If fN materia! is to be used in any area, I certify thaQ use of such fill will not adversely affect adjacent properties. If use of fili is found to advers�ly af�ect adjacent properties, the orn+ner may be cited for viala#ing the conditions of the building permit issued under the attached permit applicatian, for lots less than one (1) acre which are elev�tecf by fill, an engineered drainage plan is required. If I am the AC�N�' (FOR�'HfE O'�il�1fE�, I pramise in good faith to inform the owner of the permitting conditions set forth in this affidavEt prior to commencing construction. I understand 4hat a separate permit rr�ay be required for elecfrical uvaric, plumbing, signs, wells, pools, air conditioning, gas, or ofher insfalfations not specifically included in the app(ication. A pe�mik issued shall be canstrued to be a license 4o proceed with khe wrork and not as authority to violate, cancel, alter, or set aside any pravisions of the technical cades, nar shall issuanc�af a permit prevenf the Building qfficia!from thereafter requiring a correction of errors in plans, construction or violatians of any codes. �very permit issued shall became invalid unless #he wark authorized by such permif is commenced within six manths of permit issuance, or if vuork aufhorized by khe permit is suspended or abandoned for a period of six(6) nnonths after the Qirrie the work is commenc�d. Nn exYension may be requested, in vuri#it�g, from the �uilding Clfficia! far a period not ta exceed ninety (9Q) days and v�riH demonstrate justifiable cause for the �xtension. If work c�ases for ninety(9q)consecutive days, the job is considered abandoned. !iil�RtdlN� 'T� t�1�iP1(�t�: Y�U�t ��IILU�� Y� ��CO�� lQT@C� {}i� �fl�ii�HgNC��'I�AIT �d�Y iE��.�'sU�T 1�i Yt3�lR - �'�YIPI� T�f1110E IFOR II�I�'�OVP��ii��llf� YC1 YOl9� i�d70�E�tYY. If�YOU IRIYI�WID TC! O�Y,�►IPV FIN��1�1�9(9, �COiV�tlJL.V �ilQYO-{'1(�U�t �ENC1��Ft��9��'7'O (�� E}E'��?Ik�iC 1r�1!(F�A101�'1C�{)I�C��Li��ili��ttT.- FLORIDA JURAT(F.S. 1,17.03) � �_, Q�fPlEFL QFt AGERtT� �OFlTf2AC7{?i��" `'� �3.GG�_ �--� Subscribed��d swo o r aff ed) ef e me th�s SubI�s r�i�jed a d swo 'to'or ffirmed before me this � 6� ~--�.bY �' I �' G�G�-1L�r'�bY r��.7 i C °� �C�Q.c Who�are p ana1C knqwn to me or haslhave produced Wha Is�are pe o y�Ily knp n ta me or haslhave produced o ' C.P�,c S,..9 a s'fiientification. �~'�-� ��(1�.�'L�C¢,�..�2� as identification. � ptary Public � t� Notary Public Commis ' ��:*='Commission#EE � �t� ,,�;� �-. � . '. Commis� iv . �°�•. JACQUELI %;;�.••••''�BondedTtwTroyFanlnstuanceB,ryP:ft5.7015� =' �;►_ OIT1R11SS1O(1#EE Q4Q52O P.F,s,,, � ;o: FJ{ it£S��+Cem Name of o ary typed,printed or stamped Name of Nota L�FP�� l�l�t��j'�{38�nsurarwe8p(}3gs.�p�g,: