HomeMy WebLinkAboutInspection Docs (2) Planning 8:Development Services RECEIVED
S � � Building &Code Regulation Division
® j 2300 Virginia Ave AUG .31018
o u Fort Pierce, FL 34982 Permitting Department
772-462-2172 Fax 772-462-6443 St. Lucie County
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: 1710-0116 JOB ADDRESS: 3 EL CAMINO REAL PORT SAINT LUCIE,FL 34952-2829
EUILDERJCONTRACTOR: WYNNE DEVELOPMENT
PEST CONTROL CONTRACTOR: EVICT-A-BUG TERMITE&PEST CONTROL INC.
PEST CONTROL LICENSE #: JB175775
We, the undersigned, hereby certify that we have pretreated the above described construction for
subterranean termites in accordance with the standards of the National Pest Control Association.
Square feet if area treated: 225 LF Chemicals used: DOMINION 2L
Percentage of solution: .05% - Total gallons used: 100
Date of Treatment: 4-28-2018 Time of Treatment: 12.30
Footing Slab
1st Treatment 11t Treatment
Re-Treat Re-Treat
Driveway Pools
1�Treatment 1't Treatment
Re-Treat Re-Treat
Other xxxy�kP imeter for F" Inspection
1�Treatment T
a-12-2018
Re-Treat
S'g ature of EWrninator Date
(Vote. There must be a completed form for each require ,treatment or re-treatment and this form must be on the job
site to be picked up by the inspector at time of each inspection or the scheduled inspection will fail and a re-inspection
fee charged.
FBC104.2.6 Certificate of Protective Treatment for prevention of termites A weather resistantjobsite posting board
shall be provided to receive duplicate Treatment Certificates as each required protective treatment is completed,
providing a copy for the person the permit is issued to and another copy for the building permit files The Treatment
Certificate shall provide the product used, identity of the applicator, time and date of the treatment, site location, area
treated, chemical used,percent concentration and number of gallons used, to establish a verifiable record of
i protective treatment. If the so//chemical barrier method for termite prevention is used, final exterior treatment shall
be completed prior to final building approval.
St Lucie County requires for the final inspection for CO,a Permanent Sticker to be placed on
the electrical panel box cover, listing all the treatments and dates of applications.
Revised 7/24/2014
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Planning&Development Services
a ^ Building&Code Regulation Division
2300 Virginia Ave,Rm 201
- • Fort Pierce,FL34982 [REC"VPr-'
Phone:772-462-2165 Fax:772-462-6443
UG 0 ��":
BLOWER DOOR TEST FORM cie County
House Infiltration Test Certification
Prescriptive and Performance Method
i
Date: Permit#: �� ��� 6
1 Contractor:
Job Address: L �^�%�s Ae j / /�q/- S v G`-c
Construction: (� New Construction—Complete ( ) Existing—After Addition
House Infiltration Test Results SLC Climate Zone 2 ��
CFM(50)= 4 -7 Test Date:
Volume= 6
ACH(50)=CFM(50)x 60/Volume= Me hanical Ventilation required less than 5 ACH
Passing results must be&ACH(50)or less ( Pass ( )Fail
FBC,Energy
The building or dwelling unit shall be tested and verified as having an air leakage rate of not exceeding 7 air changes per
hour in Climate Zone 1,2 and 3 air changes per hour in Climate Zones 3 through 8. Testing shall be conducted with a
blower door at a pressure of 0.2 inches w.g.(50 Pascals). Testing shall be conducted by either individuals as defined in
Section 553.993(5)or(7),Florida Statutes or individuals licensed as set forth in Section 489.105(3)(f),(g)or(i)or an
approved third party. A written report of the results of the test shall be signed by the party conducting the test and
provided to the code official. Testing shall be performed at any time after creation of all penetrations of the building
thermal envelope.
FBC,Residential
Where the air infiltration rate of a dwelling unit is less than 5 air changes per hour when tested with a blower door at a
pressure of 0.2 inch w.c.(50 Pa)in accordance with Section R402.4.1.2 of the Florida Building Code,Energy Conservation
the dwelling unit shall be provided with whole-house mechanical ventilation in accordance with Section M1507.3.
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Testing Company
Company Name: Pro Duct Services Address: 1915 Rio Vista dr., Fort Pierce, fl.
I hereby certify that the above House Infiltration results demonstrate compliance with FBC Energy Conservation
requirements in accordance with Section R402.4.1.2 Climate Zone 2.
Signature:'�� - -
Printed Name: Michael Faurot
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License/Certification#: 5059122
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RECEIVED
JUL 0 2 2010 v
Professional Insulators of South Florida
Permg Department
St. Lucie County FTC Insulation Installation Certificate
To: St Lucie County Date: June 19,2018
Re: Lot/Block:
Address: 3 El Camino Real Project:
The rsigned hereby certifies that insulation has been installed in the above described properti as follows:
1. Exterior CBS walls have been insulated with: Spray-on Cellulose
Thickness in inches: Fiberglass Blankets
Manufacturer: Fi Foil Rock Wool Blankets
Density: X Aluminum Foil
R-Value:' R 4.1 Rigid Board
Polystyrene
Other
2. Ceilings(level)have been insulated with: Spray-on Cellulose
Thickness in inches: 11.1" X JFiberglass Blown
Manufacturer. Climatepro Rock Wool Blankets
Density: Aluminum Foil
R-Value: R-30 Polyurethane
Ouen Cell SPF
Ceilings(Inaccessible)insulated with: igi
y-on Cellulose
Thickness in inches: 9.5" rglass Blankets
Manufacturer: Johns Manville ion Barrier
Density: Fiberglass Blown
R Value: R-30 --�-�
'"� t;: _.. lose Loose Fill
�=- Cell SPF
3. Interior kneewalls have been insulated with: glass Blankets
Thickness in inches: glass Loose Fill
Manufacturer: Wool
Density: fiberglass Blown
R-Value: is a ulose Loose Fill
• Open Cell SPF
4. Garage partition walls of A/C living area have X Fiberglass Blankets
been insulated with: Rock Wool
Thickness in inches: 3.5" Polyurethane
Manufacturer: Johns Manville Spray-on Cellulose
Density: Open Cell SPF
R-Value: R-11
S. The following have been insulated:
�.• 81!LbCO!ItJr i•,
``� .'�. �• yam,
VVYNNE BUILDING CORP. r �
General Contract/Builder :J► MN
SEAL
2002 =�=
CBC1254041
Competency# '•., �'• ;•`�
Professional Insulators of South Florida,Inc. ••.•�s•at���••�'�,
i
Insulation Contractor
By: By:
',; RECENED
D?t n ri y -OL�1€�:�r►��. �i�e��
i 'dn
JU N 15 7018naAft
Permitting Departme m
St.Lucie Courts
.v
�- 7� :�
FaX -46 6 44
pen fitNOrnbi3t.
Adtim--SS;
THr:l'3NDERSIGNEO HERESY REQUEST RELEASE OF ELECTRICAL POVVER TO THE A90UF DESCMBED
PROPERTY,FOR A PMOD NOT TO VCCMD`T141RTY(30)QAYS, FOR THE P U W.OSF OF1EMNty SYStEMS
AND EQUIPMENT IN PREPARATION.f.OR A-RNAL.TNSPE'MON. IN EONS MATION OF APPROVAL OF T J
WE-Hmwi D M)RFE-M FOLLOWS'
I. IhIs,l arr erary power r4im is Ttiauested forth�aboVeeaW Pose 0*,and there will be nb
i o upanty of any tpe,other than'that geririi�ed by cohWaction'dudfig thfs tjft period.
2. As v�Iti spss W our sigr'rft*,v i-e hemby agree to abide by all Wms and conditions of this agmement,
includiiig Building DiviSfon.Pbky,which is IncorpoMted herein by reference.
3. Aff conditions:and i�equireftnts IiSted'In the attaktied document entitled"Requlr. ments for 30 Day
power for7es 91'tiaue rr fulfilled arid.ffif�premise is ready for compliance inspection.
4. All reguestrs for'an eDderisiori beyond 30 days most tee rnade,in will 3g to the.Building Offlrial stadng
the raa a�ri for file req Povugr maybe re�moved-ftin the sfta andjj r a'stop llyork.Order issued if
the Final Inspection has riot faeen appmved within 3lydays. A few of$100.00 wiff be ragg ired to lift
the Stop work Order.
WE HERSY RELEASE AND AGREE TO HOLD HAML ,ST. LUCIE COUNTY,AND THEIR EMPLOYEES FROM
ALL LIABII ES AND GLATMS•O-F-ANY TYPE OF NATURE WW(;H MAY AME NOW OR IN THE FUTURE OUT
OF THE TPANSAC"ICON,INCLUQIOO ANY CM.t-A *v'dhtai MAYBE INCURMD OUE'TO THE
DSMNECTtON OFaECMCAL PO' R'TM M4Z EVEW OF vZOLm. ON Of TffX AGREEKOTr.
E�W�fERSIC'' DATE
n1 NTRAC` ORS DA7E �
F,LECTRICAL CONT A CMR,SIGfVA' Upm DATE
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LStr-� L000/ 000d 9L0-1 999L8L8ZLL -W08 j 9Z=£L 8 L 9 L
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Planning &Development Services
- J _ _ Building &Code Regulation Division
0 2300 Virginia Ave
• Fort Pierce, FL 34982
- - 772-462-2172 Fax 772-462-6443
i
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: ° -
hr l( ] B ADDRESS
BUILDER/CONTRACTOR: _ '►�ew )I Z2 n cpgk
PEST CONTROL CONTRACTOR: EVICT A- UG TERMITE&PEST CONTROL INC.
PEST CONTROL LICENSE #:JB175775
We, the undersigned, hereby, certify that we have pretreated the above described construction for
subterranean termites in accordance with the standards of the National Pest Control Association.
Square feet if area treated: .00 JX10 Chemicals used: DOMINION 2L
Percentage of solution: .05% _ Total gallons used:
Date-of Treatment: _Time of Treatment: 2--
Date - -- —
Footing Slab
1st Treatment Ist Treatment
Re-Treat Re-Treat
A�E)riv ay Pools
1st Treatment 1st Treatment
Re-jfeat Re-Treat
Other a d l Perimeter for Fi specti n
lst Treatme t
Re-Treat
Signature of E i Dqk6i
iNote: There must be a completed form for each required treatment or re-treatment and this form must be on the job
site to be picked up by the inspector at time of each inspection or the scheduled Inspection will fail and a re inspection
i
fee charged.
F8C104.2.6 Certificate of Protective Treatment for prevention of termites A weather resistant jobsite posting board
shall be provided to receive duplicate Treatment Certlffcates as each required protective treatment Is completed,
providing a copy for the person the permit is issued to and another copy for the building permit Files 777e Treatment
Certificate shall provide the product wised,Identity of the applicator, time and date of the treatment,site location, area
treated, chemical used,percent concentration and number of gallons used, to establlsh a verifiable record of
protective treatment. If the soil chemical barrier method for termite prevention is used, final exterior treatment shall
be completed prior to final building approval.
St Lucie County/ requires for the final inspection for CO, a Permanent Sticker to be placed on
the electrical panel box cover, listing all the treatments and dates of applications.
Revised 7/24/2014
I
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KE.LLER`, SCHLEICHER & MacWILLIAM ENGINEERING AND TESTING, lNC.
MARTIN (772)337-7755 P.O. BOX 78_1377, SEBASTIAN,, FL 32978-1377 SEBASTIAN (772)589-0712.
PALM BEACH (561)845-7445 www.ksmengineering.net. MELBOUR IE(772)768-8488
i9093
FAX(561)846-8876 E-Mail: KSM@KSMENGINEERING.NET ST.LUCIE(772)589-6469
C.A.: 5693 FAX,(772)589-6469
SOIL COMPACTION REPORT
ASTM D 1657 and ASTM D 2922
DATE TESTED December 6,2017 KSM JOB# : 173680-1d/SS/ct
PERMIT# 1710-0116
CONTRACTOR Wynne Development
JOB LOCATION : 3 El Camino Real.
Spanish Lakes 1
Port St Lucie, Florida
ITEM TESTED Compacted Foundation Fill
TEST LOCATION DEPTH * PEN DRY MAX. DRY PERCENT
OF SAMPLE READ DENSITY PROCTOR VALUE .COMPACTION
1. N.E. 0"- 12" 44 108.0 111.7 96.7
2. S.E. It45 100.2 It97.8
3. Center . 40 106.7 95.5
4. S.W. 47 110.4 98.8
i
5. N.W. 42 107.3 96.1
Soil Description:
Brown.Sand 113.0 -
with Clay W I I I 1 I I I
In Place Moisture: E I I I I I I I
f6.3 Percent I
G 112.0
Optimum Moisture: H
11.8 Percent. T
111.0 i _ • _. — — —. —. _..
Max. Dry Density: p I I I I ( I
111.7 P.C.F.
C 110.0
@.Test Locations The 1 I I ! I !
Density& Penetrometer F
Readings In, the, 109.0 L
I Degree of Compaction Meets D
Minimum Re�c�uired
o so ®s R
fortedM—HROJI. Y 108.0 1—M ;� eP�to Natural Grade. 8 9 10 11 15♦ . Natural
6 - Moisture- /o of Dry Wei lht
o
No : Cr o J N0
u I lP��Pof-.. ,U ` Perm t 9 Z418
� � S IW17.
s+der . o t. L 9 p�
Or. S itil.�9f�iDF+J';;St c County Building Department UCJ�, CCV artfitn
Err► i�W) lakes.com my FC t
s�ePD��tssysoss°gs, �
Ronald G. Keller, P.E.: 37293/St Lic. No.:860 / Julie E. Keller, P.E.:68366
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112/07/2017 17:31_ 77258964� KSM ENGINEERING PAGE 02/05
OIL
i „NJAW
KELLER, SCHLEICHER & MaCWILL.IAM ENGINEERING AND TESTING INoC.
MARTIN (772)337-7755P.O. BOX 78-1377, SEBASTIAN, FL 3297$-1377 SEBASTIAN MELBOURNE(321)768-8488
PALM BEACH(561)845-7445 www-ksrnengineering.net ST.I`UCIE(7-72)229-9003
j FAX(561)845-8876 E-Mail: KSM@KSMENCINEERINGAET FAX(772)589-6469
G.A.:5693 SC>'lL,COMPACTION REPORT
ASTM D 1657 and ASTM D 2922
DATE TESTED December 6, 2017 KSM JOB# : 173680-1 d1SS/ct
PERMIT# 1710-0116 �=
CONTRACTOR 'Wynne Development
JOB LOCATION 3 El Camino Real DEC 0 2017
Spanish Lakes 1
Port St Lucie, Florida
ITEM TESTED Compacted Foundation Fill
TEST LOCATION DEPTH " PEN DRY MAX. DRY PERCENT
OF SAMPLE READ DENSITY PROCTOR VALUE COMPACTION
1. N.E. 0"- 12" 44 1.08.0 111.7 96.7
j 2. S.E. " 45 109.2 ` 97.8
S. Center it40 105.7 95.5
4. S.W. 47 110-4 98.8
5. N.W. 42 1077.3 96.1
Soil Description:
Brown Sand 113.0 '
with Clay W
In Place Moisture: E
6.3 Percent
I _
Optimum Moisture: I I i I I I
11,8 Percent
Max. Dry Density: P
111..7 P.C-F, 1 I I I I 1
C i i i t ► i
110.0 .._-.. .. _. _ _.. _..
@ Test Locations The I i 1 Ii I
Density& penetrometer F
j Reading$ Indicate the
Degree of Compaction Meets
I
Minimu Iris, I I l I 1
nL
�.+� R I
forS%aKle t, •� •. Y 108_a
* P1 �9ti ral Grade.
o ""3,"' 8 9 10 11 12 13 14 15
Ry 11Q 5836�d:•i
12/7 y Moisture-%of Dry weight
cc w
e F J
lm ��,,�; �ro •4 ' F�L
LL ,� Q
Fax t irounty Building Department
Email tiP,tq a� ;x�lhlakes.com
I
n 4T lm9 i c, i;.. ni„-Asn 1 .I,dio F Kndlp.r. P.F-._66366
1�
i
_ Planning &Development Services
7Ji c E_-� Building &Code Regulation Division
® 2300 Virginia Ave
® P _ Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: f - (� (i'G JOB ADDRESS: 3 GJL O;rAtti Vlo
BUILDER/CONTRACTOR: & ( - fz
PEST CONTROL CONTRACTOR: EVIL - -BUG TERMITE&PEST CONTROL INC.
PEST CONTROL LICENSE #: JB175775
We, the undersigned, hereby certify that we have pretreated the above described construction for
subterranean termites in accordance with the standards of the National Pest Control Association.
i
Square feet if area treated: 0 Chemicals used: DOMINION 2L
Percentage of solution: .05% Total gallons used:
Date of Treatment:/2 Time of Treatment:
,Footing j y)Slab
1st Treatment ✓ 1st Treatment
Re-Treat Re-Treat
Driveway Pools
1st Treatment 1st Treatment
Re-Treat Re-Treat
Other Perimeter for Final Inspection
1st Treatment
Re-Treat 4Dae'
atureof Exterminator
Note: There must be a completed form for each required treatment or re-treatment and this form must be on the job
site to be picked up by the inspector at time of each inspection or the scheduled inspection will fail and a re inspection
fee charged.
FBC104.2.6 Certificate of Protective Treatment for prevention of termites A weather resistant jobsite posting board
shall be provided to receive duplicate Treatment Certificates as each required protective treatment is completed,
providing a copy for the person the permit is issued to and another copy for the building permit files The Treatment
Certificate shall provide the product used, identity of the applicator, time and date of the treatment, site location, area
treated, chemical used,percent concentration and number of gallons used, to establish a verifiable record of
protective treatment. If the soil chemical barrier method for termite prevention is used,.final exterior treatment shall
be completed prior to final building approval.
St Lucie County requires for the final inspection for CO, a Permanent Sticker to be placed on
the electrical panel box cover, listing all the treatments and dates of applications.
Revised 7/24/2014
I
L
i
i
'KELLER, SCHLEICHER & MaCWILLIAM ENGINEERING AND TESTING, INC.
:MARTIN (772)337-7755 P.O. BOX 78-1377, SEBASTIAN, FL 32978-1377 SEBASTIAN (772)589-0712
8488
:PALM BEACH (561)845-7445 www.ksmengineering.net MELBUUR IE(321) 229-9093
FAX(561)845-8876 E-Mail: KSM@KSMENGINEERING.NET ST..LUCIE(772)229-9093
C.A.:5693 FAX(772)589-6469
SOIL COMPACTION REPORT
j ASTM D 1557 and ASTM D 2922
DATE TESTED December 6, 2017 KSM JOB# : 173680-1 d/SS/ct
i
PERMIT# 1710=0116
CONTRACTOR Wynne Development
JOB LOCATION 3 El Camino Real
Spanish Lakes 1
Port"St Lucie, Florida
j
ITEM TESTED Compacted Foundation Fill
TEST LOCATION * PEN DRY MAX. DRY PERCENT
OF SAMPLE DEPTH READ DENSITY PROCTOR VALUE .COMPACTION
1: N.E. 0" - 12" 44 108.0 111.7 96.7
2. S.E. 45 109.2 97.8
3. Center 40 106.7 95.5
j 4. S.W. 47 110.4 98.8
5. N.W. 42 107.3 96.1
Soil Description: -
Brown Sand 113.0
with Clay W 1 ! I I I I I
In Place Moisture:
6.3 Percent I
G 112.0
Optimum Moisture: H j I I I I I
11.8.Percent T j I I I I I
ill 0
Max..Dry Density: P
I " 111.7 P.C.F. I I
I C 110.0
@ Test Locations The
Density& Penetrometer F
Readings Indicate the 109.0
Degree of Compaction Meets D I I !I I
MinimuRRfe tMU11'a
o�s R I
.,
for S09W, �'�c� o Y 108.0 -�—.._�._..�.._..T: _.�_..—�.._..T.._ .,
* Pti ®n Natural Grade. g 9 10 11 12 13 14 15
R e Ily Submitt6ed:% dP
o. 683
12/7 • Moisture-%of Dry Weight ; y
iA
e W RECEIV
r •.FC
l Fax a°°Si. �1✓ounty Building Department DEC 11 2017
Email to.°� ®' pigAlakes.com
Permitting Depa�
St. Lucie Cow
f Ronald G. Keller, P.E.: 37293(SI Lic. No.:860 1 Julie E. Keller
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JOSEPH E. SMITH, CLERK OF THE CI.RCUIT COURT — SAINT LUCIE COUNTY
FILE # 4356800 OR BOOK 404-9 PAGE 1453, Recorded 10/06/2017 11:10,34 AM
STATE OF FLORIDA
ST.LUCIE;COUNTY
THIS IS TO CERTIFY THAT THIS IS A'
TRUE AND CORRECT COPY OF THE c
ORIGRdA 1- '
H E.SMIIT LERK °
PBBMR NUMBER: �� to n•Yr tl
f utk
e _oF e0��ve = CT T6 2017
The undersigned hereby given notice that improvement will be made to certain real properly,and in accordance with Chapter 713,
Florida stamms the Following information is provided in the Notice of commencement
1.DESCRIPTION.OP PA T-ILegal dcscription and street address)TAX POLIO NMMEI-3 41 A—S n 1=1 7()1^0 0 0 3,
WBDrMION Spa rOM TRACT, L71P XIMG UNTT
Or t� •Sec ion 6. —
31
2.GENERALDESCRlP1LONOPIItZBROVED3E4T:`iiYq1>a� $IR?Z_, Srd'eigee
1 I OWNER WORMATJON: a Name Wsn na 8 ti i 1r3 i sz7 ^e�xz c+r a t i on
r b.Address 8000 S- US1, Suite 402, PSL,, FL 349.52 a intetrst in piopesty
d.Name and address of fee simple titleholder(if other than owner)
4:CON TRACTOR'S NAME,ADJ)I=S AND PHONE NUMBER Wynne Development Corporation
8000 S. •USI, Suite 402, -PSL, FL�Ac52_ Z72—s2s-557
S.SURETY'S NAME,ADDRESS AVID MON2 NUMBER AND BOND AMOUNT:
6.LENDER'S NANM ADDRESS AND PRONE NUMBF,R:
7.Persons within the State of Fioride•designated byy.Owner upon whom notices or other da.cuments may be served as provided by
Section 713.13.(1)(a)7.,k'lorida$tattites:
NAM ADDRPSS AND PRONE NUN>BSREAOug ,Brantley 1, Silver, Oak• Dr— PSL, FL. Zfll`�8'
8.Tn addition to himself or herself;Owner designates the following to receive a copy of the Uenoes Notice ssprovided in Section
713.13(sxb),Florida Statutes:
NAA2 ADDR "AHD FUONE N[JitD M
9.Expiration date of notice of commencement(the expiration date is I year from the dataof recording unless a diffment-date is
specified) :20
3DE1(z TO OWNER:ANY PAYMEMS MADE RX THE OW—M 6E'E:R TS•iE MMAMON OFTHE 11=CE OF GOMMENt MBNr
Agfi CO_NC,IpPREt? RAXW=UNDER CHAP=713.PART!SPI`TtAN 713 es R]A Q•r'A•rOrAC AND CAN RECL=
1N YOUR P&)=•Ly=FCIR YMPROVP.teM TO YO nt PAOPERTy A NME OF•C MM2N�CEM2MrA"JS't'S RECORDED A14D
N pQ � M IDI e�ORP Tp p(lte r 1NCpEC19 7 y-QU 1 iN=M OBTAlN 1ANCM .==LX R=YOUR
•::•L+DER'4R�AN'P•4'i'(9Rt38'f$EFOR$GOh4MirNCR3GW9R �2t;(�'ORD9VCrYE?�IRI G�G'1?tC2OFG(5MM$lyt.��• .,
Matthew Lyle Wynne, V'ce-President
j Signature of Owner or Print Name and Prdvide Signatory's V14. OMee
OwneesAuthoriW OtHcer/Director)Part=/Mnmager
State of Florida
Countyof. sf-_ Y.17t+f,e. 20
•The foregoing instrument was acknowledged before.rrie this `ay of / '
By Matthew Zy2e Wynne ,as
(Name of person) (Type of auzhodty...e.g:Owner,officer;Bost-attomcy in Fact)
• �rWyrtne Building Cvrtsot^aton '
(Name ofparty on behalf of whom instrument w4execoted) Personally Knawa Y or produced the follnwingtype pfID-
�'Yt�
t NatgrypubAsStoteotPtorida
xaDV FAyCwnUWwGGo38W2
(Printed Name of Notary Public} ( ature of Notary Public) l3val)
Under penalties of perjury.I declare that I have stied 1fit:foregoing and that the feats in it ale true to the best of trey knowledge.and
i trd3ef(rectlon 92.525,Florida Statutea). •
Sigaaturc(s)of owner(s)br Owner(s)'Authorized Officer/Dircctur/Partnerr/Manager who signed Above
ay
By:_
Ra.�►�1lAerormssl
,
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