EL-08-1053Project Address Parcel Number
9304 N MIAMI Avenue 1131010340170
Miami Shores Village, FL Block: Lot:
Owner Information Address Phone Cell
TONY CRAPP
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores , FL 33138 -0000
Phone: (305)795 -2204
Contractor(s)
CARIBE S ELECTRIC
Phone Cell Phone
(786)255 -6212
Type of Work: install 2 exhaust fans
Additional Info:
Classification: Residential
Fees Due
CCF
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$0.20
$160.00
$3.00
$4.00
$167.80
Authorized Signature : Owner / Applicant / Contractor / Agent
Building Department Copy
Monday, June 16, 2008
€tf�
etitirr
Kleitt
Expiration: 1 /13/2000
9304 N MIAMI AVE
MIAMI SHORES FL 33150 -2244
(305)759 -5225
Total
$ 0.00 $ 0.00
Payment Type :
Amt Paid I Amt Due
$ 0.00
1101 JUN 2 3 PAID
Valuation:
Total Sq Feet:
Applicant
TONY CRAPP
$ 1,000.00
0
Available Inspections:
Inspection Type :
Final
Rough
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining
thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this
permit I assume responsibility for all work done by either myself, my agent, servants , or employes . I understand that separate permits are required for ELECTRICAL,
PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work .
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning . Futhermore • I authorize the above -named contractor to do the work stated .
June 16, 2008
Date
1
G fit(bX bppr -
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: Electrical
Tenant/Lessee Name
E -MAIL:
Job Address (where the work is being done)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Owner's Name (Fee Simple Titleholder) //A / i6 r e Z , 4ff # 7
Owner's Address 73 e z/` ki c ie:O.P",/ /5
City ,4%, "d1 . 4Ugtate Zip
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Contractor's Company Name C.Acrte • g 'G- Iri C Phone # ( e 49 •
Contractor's Address 1 1"-s 4 O �JI - J - �
City --- (10 , State State - Zip 330 tit- •
Qualifier Name N2j -k 41%- , DL,q--- Phone #
State Certificate or Registration No.ea-ABoS34�. Certificate of Competency No. CYO OGt' �
E-MAIL: C4 G Me
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $
Type of Work: ❑Addition
Describe Work:
Alteration
2.
['New
Permit No. I.L. Oe • 1053
aster Permit No.CO8• q8
Phone #
Square / Linear Footage Of Work:
❑ Repair /Replace ❑ Demolition
h, "k '
********* otoYie**** Se****&a oY4rokoY xaYaYdceY*x4c****F Y******** Y*eY******** / xxxxxxxa *xxxmx oYxoY***
Submittal Fee $ /" Permit Fee $ /� ®e CCF $ 01 CO /CC
Notary $ 0 Training /Education Fee $ 0.a Technology Fee $ 4. W
Scanning $ 3.b Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ (41 . W
See Reverse side ->
110 4S 9�.
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgoetider: ZAddre�s
•
City ` , ; s') (P A,* State Zip
Application is hereby made to obtain a permit to do the.work.and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. 1 understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection, fee will be charged
Owner or Agent
The foregoing instrument was acknowledged before me this
day of 5 20 by
who is personally kno
L'f ed
NOTARY PUBLIC:
9:xx *xx a:aY x*** dr** dczxxx *le * xx x ****** x 4c** xxx xxxx
APPLICATION APPROVED BY:
(Revised 02/08/06)
Sign:
Print:
My Commission Expires:
Signature
Contractor
The foregoing instrument was acknowledged before knz this ( .
day of _SL'+ . , 20 Oby $ PCS'2
who onally known to me or who has produced SCAPVLU
Tt as identification and who did take an oath.
NOTARY PUBLIC:
tre Examiner
Engineer
Zoning
REMODEL
AND FLOOR
TWO BATHROOMS, INSTALL
�LIa �
TILE WALL
r
Inspector Comments
AJ S( Ar etzein,
PI lac-; ( iferit
_..--------'
Passed
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re- inspection fee is paid .
Inspection Date: 07/08/2008
Inspector: Grande, Claudio
Owner: CRAPP, TONY
Job Address: 9304 MIAMI Avenue N
Miami Shores Village, FL
Project: <NONE>
Contractor: EDDIE CONTRACTOR CORP
Building Department Comments
Monday, July 7, 2008
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
JUL 10
Block:
Permit Type: Residential Construction
Inspection Type: Framing
Work Classification: Alteration
Phone Number (305)759 -5225
Parcel Number 1131010340170
Lot:
Phone: (786)986 -4676
Page 1 of 2
ELECTRICAL WORK FOR INSTALLATION OF2 NEW
EXHAUST FANS IN BATHROOM
Passed
Inspector Comments
i
� 69B
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
•
Inspection Date: 09/08/2008
Inspector: Devaney, Michael
Owner: CRAPP, TONY
Job Address: 9304 MIAMI Avenue N
Project: <NONE>
Contractor: CARIBE S ELECTRIC
Building Department Comments
Friday, September 5, 2008
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Miami Shores Village, FL
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Block:
Phone Number (305)759 -5225
Parcel Number 1131010340170
Lot:
Phone: (786)255 -6212
Page 2 of 2
REMODEL TWO BATHROOMS, INSTALL TILE WALL
AND FLOOR
Passed
Inspector Comments
CC R 10 — ®d?
f -
7 __
2 }O
I
hit,
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Date: 09/10/2008
Inspector: Rodriguez, Jorge
Owner: CRAPP, TONY
Job Address: 9304 MIAMI Avenue N
Miami Shores Village, FL
Project: <NONE>
Contractor: EDDIE CONTRACTOR CORP
Building Department Comments
Tuesday, September 9, 2008
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Si 2
III
Block:
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Alteration
Phone Number (305)759 -5225
Parcel Number 1131010340170
Lot:
Phone: (786)986 -4676
Page 1 of 2
REMODEL TWO BATHROOMS, INSTALL TILE WALL
AND FLOOR
•
Passed �/�
Inspector Comments
cc �, ` ��
SE COND BATHROOM
Faile
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Date: 08/25/2008
Inspector: Rodriguez, Jorge
Owner: CRAPP, TONY
Job Address: 9304 MIAMI Avenue N
Project: <NONE>
Contractor: EDDIE CONTRACTOR CORP
Building Department Comments
Friday, August 22, 2008
Miami Shores Village, FL
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Residential Construction
Inspection Type: Drywall
Work Classification: Alteration
Phone Number (305)759 -5225
Parcel Number 1131010340170
Lot:
Phone: (786)986 -4676
Page 1 of 2
REMODEL TWO BATHROOMS, INSTALL TILE WALL
AND FLOOR
6
Passed
Inspector Comments
CR AS REINSPECTION FOR INSP- 85725. West bathroom OK,
pending inspection on east bathroom. 7/8/08 CG
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
................
................
Inspection Date: 08/20/2008
Inspector: Grande, Claudio
Owner: CRAPP, TONY
Job Address: 9304 MIAMI Avenue N
Miami Shores Village, FL
Project: <NONE>
Contractor: EDDIE CONTRACTOR CORP
Building Department Comments
Wednesday, August 20, 2008
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Residential Construction
Inspection Type: Framing
Work Classification: Alteration
Phone Number (305)759 -5225
Parcel Number 1131010340170
Lot:
Phone: (786)986 -4676
Page 1 of 2
ELECTRICAL WORK FOR INSTALLATION OF2 NEW
EXHAUST FANS IN BATHROOM
•
Passed
Inspector Comments
s re
'
62,A, � � /1„,
/ ce �r°7, e:
elP®j°t e'l�
9
, ���.� ��,
-S `'
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
aria
Inspection Date: 07/22/2008
Inspector: Devaney, Michael
Owner: CRAPP, TONY
Job Address: 9304 MIAMI Avenue N
Project: <NONE>
Miami Shores Village, FL
Contractor: CARIBE S ELECTRIC
Building Department Comments
Monday, July 21, 2008
Inspection Worksheet
Miami Shores Village
i gc )
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
05-1V,
Permit Type: Electrical - Residential
Inspection Type: Rough
Work Classification: Addition /Alteration
Phone Number (305)759 -5225
Parcel Number 1131010340170
Lot:
Phone: (786)255 -6212
Page 2 of 2
REMODEL TWO BATHROOMS, INSTALL TILE WALL
AND FLOOR
/ 8
... 7/
Passed -' 6
Inspector Comments
(S0-(,FIAT.-__)
0 a
64 bpi." A
0k— /
P2,e- L rri. tr
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Inspection Date: 07/24/2008
Inspector: Grande, Claudio
Owner: CRAPP, TONY
Job Address: 9304 MIAMI Avenue N
Miami Shores Village, FL
Project: <NONE>
Contractor: EDDIE CONTRACTOR CORP
Building Department Comments
Wednesday, July 23, 2008
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Residential Construction
Inspection Type: Drywall Screw
Work Classification: Alteration
Phone Number (305)759 -5225
Parcel Number 1131010340170
Lot:
Phone: (786)986 -4676
Page 1 of 2
Project Address Parcel Number
9304 N MIAMI Avenue 1131010340170
Miami Shores Village, FL Block: Lot:
TONY CRAPP
Contractor(s)
EDDIE CONTRACTOR CORP
Phone Cell Phone
(786)986 -4676
Approved: In Review
Comments:
Date Approved: : In Review
Date Denied:
Type of Construction: BATHROOM REMODEL
Stories:
Front Setback:
Left Setback:
Bedrooms:
Plans Submitted:
Certificate Date:
Bond Retum :
Occupancy: Single Family
Exterior:
Rear Setback:
Right Setback:
Bathrooms:
Certificate Status:
Additional Info:
Classification: Residential
Fees Due
CCF
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$2.40
$0.80
$300.00
$3.00
$7.50
$313.70
Authorized Signature : Owner / Applicant / Contractor / Agent
Building Department Copy
Monday, June 16, 2008
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores , FL 33138 -0000
Phone: (305)795 -2204
Ciaaft
(305)759 -5225
Total
$ 0.00 $ 0.00
Payment Type :
Amt Paid I Amt Due
,W1)01 JUN 2 3 PAID
$ 0.00
Valuation:
Total Sq Feet:
June 16, 2008
Date
Expiration: 12/13/2008
Applicant
TONY CRAPP
$ 4,000.00
0
Available Inspections:
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining
thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this
permit I assume responsibility for all work done by either myself, my agent, servants , or employes . I understand that separate permits are required for ELECTRICAL,
PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning . Futhermore , I authorize the above -named contractor to do the work stated .
1
Owner lrlfprination Address Phone CeII
9304 N MIAMI AVE
MIAMI SHORES FL 33150 -2244
Inspection Type :
Framing
Drywall Screw
Final
PERMIT #:1200
Miami Shores Villa. e
•
APPROVED
BY__
W
Fa
- -
ZONING DEPT
BLDG DEPT
,
ern-imp,
' if'
-',.
--
,0).-4.,e
SUBJECT TO COMPLIANCE WITH ALL FEDERAL
i STATE ANn COUNTY Rt.)! rs ANTI rzPr=111__ATIOIS
l ee Loom 2 1
3 O9 Pr Ito Fl 3 3
0 to 9 FA
7
eW2 1
Re
1 v eu? Roo
+Mom,
4 , 9 px7ve-7-t-pa Rleccer7;evel e a 1 jff k
;19 E9ei
IA-2---
---------
AA 0
`mac
BUILDING
PERMIT APPLICATION
FBC 2004
Contractor's Company Name ateiee
®.per44.
2- -- OAT t/
--ND' 6 Sa'a .
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit Type (circle): (wilding) Roofing
i
Owner's Name (Fee Sim le Titleholder) Z / ri' cam.
Owner's Address l ' 4 / �' /'
City ,l(s'A!7 SX
Tenant/Lessee Name ->-,/
Job Address (where the work is being done) 93 .04( ✓V /tom` Q'n . e i r&t_
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL #
Is Building Historically Designated YES NO ✓°
Permit No. w` l
Master Permit 11 To.
Phone # 3 ®5 73 ttJ / /
Zip 33/5
Phone #
Phone # (� S °-\ fr V4
Contractor's Address ::- %1 -. try -C
City Pk State Zip .5 /
� g � s'I,
Qualifier Name ' " - ,,,z—d-77-6-447:3 Phone # - RC. i C V4
State Certificate or Registration No. e" &" /J '- O Ve Certificate of Competency No. ( ?' 9 I
Architect/Engineer's (ifgpplieable) Phone #
Value of Work For this Permit $ /01600 Square / Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration ['New i Repair/Replace ❑ Demolition
Describe Work: I `: ? .�\ L L 1 %L 1 4 t F L- a
******* ******,x********* ***** *** ***** :* F ************** ************* ** x *********
Submittal Fee $ Permit Fee $ 3 e: 0 0 - CCF $ 2 •46 CO /CC
Notary $ 0 Training/Education Fee $ 0 pb Technology Fee $ 1.5
Scanning $ 3 ' ) Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ 313 :10
See Reverse side -
Bonding Company's Name (if applicable)
Bonding Company's Address
City State lela
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address IAC4C
City State
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and MR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of comme anent must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In . e abs nce of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
who is personally known to me or who has produced
NOTARY PUBLIC:
Sign: �' � . _ Sign:
Print: ,y` 1,./7'/�� Print:
My Commission Expires:
My Commission Expires:
(Revised 07/10/07)
Signatur Signature
Owner or Age t � Contractor
The foregoing instrument was acknowled ed before me this - The foregoing instrument was acknowledg before me this
day of i li , 20 ek by A. '/» (-)' day of Ale , 20 by Y fr
who is personally known to me or who has produced
7 i4e'rpt ;>'
NOTARY P
** ****** **• x***** ******* ************+x****** *********** *****:****+x+x****** ** * *** * *** x**** *** ***** ********+x****
APPLICATION APPROVED BY: Plans Examiner
Engineer
Zoning
! 111111 ttlll 14111 lltll MU 11111 tit111111 1111
CFN 2O08RO514542 OR .K 26444 Ps 10500 (1Ps )
RECORDED 06123i 2008 12:101:29
HARVEY RUIVII'dv CLERK OF COURT? MIAMI -DALE COMM FLORIDA
This Instrup6Pr� armed e �� LAST PAGE
Name ���� -'
Address • '�,Sy'
Permit No.
STATE OF _
COUNTY OF
I HEREBY CERTIFY that this rs a t py of the
original filed to this office on a c daof
, A D 20
and Official Seal.
c cult and County Courts
ad tn.
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Description of property: (legal description of property, and street address if available)
P -Te' y4 ,L(, a-ex a` /t-b4; v),> P le P/
2. General description of improvement:
NOTICE OF COMMENCEMENT
.Dios- ,I Xi/ a' / a /. -0/`
3. Owner information TOIV Boa .�.Q ew �, a' .
a. Name and address: �/
b. Interest In property: ?3p/ , /, .-Z?/ PJvf?c-
,c. Name and address of fee simple titleholder (if other than owner):
4. Contractor. /
a. Name and address: E't> 4�f` �' ® p*'/ t 1 alp /Zp
b. Phone number: .-N 0 -r 94,740
5. Surety
a. Name and address:
b. Amount of bond $
c. Phone number:
6. Lender
a. Name and address:
b. Phone number.
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes:
a. Name and address:
b. Phone number.
•
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section
713.13(1)(b), Florida Statutes:
a. Name and address:
b. Phone number.
8. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date Is
specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13,
FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS 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
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
STATE OF FLORIDA, COUNTY OF DADE
MARIA E. CANO
a,v COMMISSION 4 00 669595
EXPIRES: May i 2011
Bonded ttw Notary l ;Urdenaitera
Tax Folio No.
Sign t #-of Owner or Owner's Authorized ' >r /Director
Partner /Manager
Signatory's Title/Office
uF f
ged before me this 29 day of 77/1"e .F ) b y "
xr �' l _' ► f person) as (type of
au ority, ...e.g. officer, true ee, o< ey in fact) for me of party on
behalf of whom instrument was executed).
Signs a of Notary Public - State of Florida
P Type, or Stamp Commissioned Name of Notary Public
Commission Number
Personally Known t/or Produced Identification
Verification Pursuant to Section 92.525. Florida Statutes
Under penalties of perjury, 1 declare that I have read the foregoing and that the facts stated in it are true to the
knowledge and belief.
Sig.rtf!" of Natural Person Signing A..ve
of my