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150 12th Street 2014 pegola , CITY OF ATLANTIC BEACH S 800 SEMINOLE ROAD J ;r ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 ACCESSORY STRUCTURE NEW RES MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 ]OB INFORMATION: Job ID: 14-ACST-283 Job Type: DETACHED ACCESSORY STRUCTURE NEW Description: pergola Estimated Value: $6,000.00 Issue Date: 11/13/2014 Expiration Date: 5/12/2015 PROPERTY ADDRESS: Address: 150 12TH ST RE Number: 170277-0000 PROPERTY OWNER: Name: ADKISSON, KENDALL B &, Address: 1916 N 1 ST ST 1916 N 1 ST STREET GENERAL CONTRACTOR INFORMATION: Name: ENHANCE OUTDOOR, INC Address: 5050 ELINOR RD 5050 ELINOR RD Phone: - - PERMIT INFORMATION: FEES: BUILDING PERMIT FEE $80.00 STATE DCA SURCHARGE $2.00 PLAN CHECK FEES $40.00 STATE DBPR SURCHARGE $2.00 Total Payments: $124.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. P � NO FILF GOTICE OF COMMENCEMENT z � __ { Tax Folio No. I / 217 rd�� State of. a�;p� County of �)t,1y a t To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of the Florida Statutes-,the following information is stated in this NOTICE OFCOMMEnNC�E�MET. n Legal Description of property being improved: ��—?S L AJ-1 -f" Address of property being improved: Sp 12*1 fre� General description of improvements: -6 l �`p f O Owner: J'k h S i zo n Address: Owner's interest in site of the improvement: - Fee Simple Titleholder(if other than owner): Name: y� Contractor: N ki Address: 21 ° Telephone No.: Vv`t• L., Fax No: qt�t 2'gEi TQD� Surety(if'any) Address: Amount of Bond$ Telephone No: Fax No: Name and address of any person making a loan for the construction of the improvements Name: Address: Phone No: Fax No: Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may be served: Name: Address: Telephone No: Fax No: In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b),Florida Statues. (Fill in at Owner's option) Name: Address: Telephone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNE Si Date: 10 f _ Before me this ( day of in the County of Duval,State Doc#2v"i 423894'+,OR BK i 695 i rage 10`5, Of Florida,has personally appeared O s'h In s '` Number Pages:'I No Public at Large,Stat of Florida,County of Duval. Recorded 10/21/2014 at 01:45 PM, �' -� - Ronnie Fussell CLERK CIRCUIT COURT DUVAL My commission expires: i or Personally Known: COUNTY •i •= MY COMMISSION#FF018841 RECORDING$10.00 Produced Identification: �;+' Or EXPIRES August 18,2n1 (4071398-0153 FloridallotaryServico.com MAP OF BOUNDARY SURVEY DESCRIPTION: WEST HALF OF LOT 5 AND 6, BLOCK 43, ATLANTIC BEACH CORPORATION ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 6, PAGE 1 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. CIL 12TH STREET 40 RIM - S.I.R.C- 5/8" — ..'.'.'.' .. LB 7261 .20 ASPHMU.1 .. FIRST COAST .... ...... ... S89'32'28"E 52.50' WEST 1/2 OF 1 ^, LOT 6, BLOCK 43 a NO IO N N I cavEfEO 72.7 01.B'E R 11.7 EAST fOF I io ^// oo L07 6, BLOCK 43 3 STORY $ o BRICK UCC /T1500 o Lu, _J a ❑,, 40 11 o� a BRICK ❑'^ Z .-.'.�..'.'.'... 15.1 En EAST 1/2 OF "11 LOT 6. BLOCK 43 .'.'.l'.-.'.'.'. NOW 91IRf WEST 1/2 OF I LOT 5. BLOCK 43 SEPTIC LID NP 0 0.3' —J N89'32'28"W 62.50' N- ,IND I1 2' S.ZIB 7261/B - IFENCE 0.4' N FIRST COAST I LOT 4 BLOCK 43 SURVEY NOTES: /f PLAT PROVIDES NO BEARINGS, THEREFORE BEARINGS ARE CERTIFIED TO AND FOR THE ASSUMED ON THE WEST LINE OF LOT 5 AND 6. BLOCK 34 FOR EXCLUSIVE'BENEFIT OF: ANGLE DEFINITION ONLY BEING NOO'00'00'E. CHANTAL 6. HOOK /2 UNDERGROUND UTILITIES. FOUNDATIONS OR OTHER WELL; -ARGO BANK. N.A. IMPROVEMENTS MERE NOT LOCATED BY THIS SURVEY. WESTCOR LAN_ 'TLE INSURANCE COMPANY FIRST COR..' :.'TLE SERVICES. INC. /3 ACCORDING TO THE FEDERAL EMERGENCY MANAGEMENT AGENCY FIRM MAP PAWEL N0. 120075 0001 D. EFFECTIVE 04111/89, .i TPs ET ADDRESS: THE PROPERTY DESCRIBED HEREON APPEARS TO LIE IN ZONE /4 THIS SURVEY PERFORMED WITHOUT BENEFIT OF AN ABSTRACT, 150 12TH STREET TITLE SEARCH TITLE OPINION OR TITLE INSURANCE. ATLANTIC BEACH FLORIDA /5 DIMENSIONS ARE SHOW IN FEET AND DECIMALS THEREOF SCALE: 1" 30' n AND ARE PLAT AND MEASURED UNLESS SHOWN OTHERWISE. c /6 ALL EASEMENTS ARE PER PLAT UNLESS SHOWN OTHERWISE. 0 /7 THERE MAY BE ADDITIONAL RESTRICTIONS THAT APPLY WHICH ARE NOT SHOWN ON THIS SURVEY WHICH CAN BE FOUND IN PUBLIC RECORDS OF SAID COUNTY. 0 o_ /8 THIS SURVEY DOES NOT GUARANTEE OWNERSHIP. /9 TEMPORARY, NON-PERMANENT IMPROVEMENTS ANO/OR NAN-MADE ITEMS SUCH AS, BUT NOT LIMITED TO THE FOLLOWING: BUILDING MATERIAL. 00 STORAGE PODS. PAVER BLOCKS, RUBBERMAID OR PLASTIC UTILITY BUILDINGS NOT ON FOUNDATIONS, VEHICLES ON BLOCKS MAY BE ON ry THIS PROPERTY BUT NOT LOCATED OR SHOWN- co /10 LEGAL DESCRIPTION PROVIDED BY CLIENT. NOTICE OF LIABILITY: THIS SURVEY IS CERTIFIED TO THOSE INDIVIDUALS SHOWN ON TFE FACE THEREOF. ANY OTHER USE BENEFIT OR RELIANCE BY ANY OTHER PARTY IS CL:)E 0. VAN KLEEC aSTRICTLY PROHIBITED AND RESTRIC7E0. SURVEYOR IS RESPONSIBLE ONLY TO THOSE FLORID REGISTEREC SURVEYOR AND R NO. 2546 CERTIFIED ANO HEREBY OISCLAINS ANY OTHER LIABILITY ANO HEREBY AESTRICiS THE RIGHTS OF ANY OifER INOIVIWAL OR FIRM TO USE THIS SURVEY, MIlFDUi EXPRESS N07 VALID WITHOUT THE :IGNATURf 6 ORIGINAL RAISED WRITTEN CONSENT O"7FE SURVEYOR. SEAL OF A FLORIDA t.ICENSED S VEYOR AND MAPPER. a i q -OVERHEAD ELECTRIC F.C.M. -FOLNO CONCHMETE MONUMENT L.M. -CONCRETE MOHp,MENT SEC-SECTION FEN -FENCE �L F.-CHAIN LINK FENCE F.I.R.C. -FOCNO IRON ROD AN)CAP P.i. -POlNT OF TANGENCY TMP- T IP CND _FLOLWD M.F. -'000 FENCE i F.I-R. -FOVN1 IRON ROD P.C. -POlNT OF LURVA TLYiE RGE- C.B. {Hppp ffEdRING F.T.P. -FOUND IROW PIPE U.E. -UTITLITY EASEMENT P.I.:�LNON JTIDN (P) -PLAT WmM -MATER METER S.I.R.C.-SE7 IRON ROD ANO LAP D.E. -DRAINAGE EASEKENI A/C A a QV T EL ELEV M.P. -M000 POLE F.N60 -FDUVO NAIL ANO DISK C G G -LNHG G GUTTER NTS- T ALE ESMT -EASEM P 6 N_PLMENEASUREO m (M1 -FIELD MEASURENEN7 il/N -RIGHT OF MAI (PR)- COR -CoRw,, HIH fC) -CALCULATED UEASIMEMENT C/L -CENTERLINEEXISTING PROJECT INFORMATION FIELD SURVEY DATE FIRST COAST LAND w PLOT PLAN ORDER N0: 20003 i BOUNDARY 01/13/2010 SURVEYING, INC. DRAWN BY: TNP w FORMBOARD 839-106 LANE AVENUE SOUTH, JACKSONVILLE, FL-32210 REVIEWED BY: TNP LL AN FOUNDATION PHONE (9 CERTIFICATE NO A L8(90 61 779 7784 CHECKED BY: V FINAL r BUILDING PERMIT APPLICA'T'ION f `: CITY OF ATLANTIC BEACH r' J FILECOPY � ` 800 Seminole Road, Atlantic Beach, FL 32233 � � @ Office (904) 247-5826 Fax(904) 247-5845 OCT 21 Job Address: Z �r8e+ Permit Nutt k fr: T_ Legal Description 1'�_rCkr>1A Parcel # � Floor Area o q. t. '�,t Valuation of Work$�n .00v Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial Residential If an existing structure,is a fire sprinkler system installed? (Circle one): Yes- No N/A Florida Product Approval# For multiple products use product app rova orm j Describe in detail the type of work to be performed: -�—,n�� �(, r' Pp Property Owner Information: !� /L� Name: yl 1/1 r Address: �� City okl State_ ip 3Zzll Phone 451- E-Mail or Fax#(Optional) Contractor Information: j� /' l Company Name: 9wAVV e_f Qualifying Agent: uclyd Gtj,� / Address: 2 vi-& e— -- P.,A4 L e�,�r City F)PM;Ae, =s ls.,a�/ State �` Zip 3z�om� Office Phone I&, • 1-%.71'?1 Job Site/Contact Number Fax# State Certification/Registration# C EC 13 ZAI q 3 Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address 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. This permit becomes null and void,fork is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period oosix a months o any time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells, Pools, Furnaces,Boilers,Heaters, Tanks and Air Conditioners,etc. 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. I here, certify that 1 have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this type ,lb will be complied with whether s eci ted herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal,state, or loca aw regulating construction or the performance of construction. Signature of Ow Signature of Contr. tor Print Name J Print Name / Swornto and subsc 'be before me Sworn to and subscribed before me this I Day of th• Day of 20 Ij pE1(TON GUIDI o��p"e •; PEYTON GUIDI 641 Ota U IC Ota UbhC MY COMMISSION#FF01684 +E �: EXPIRES August 18,2017 :,,._ +,�..Y..P: FloddallotaryServlce.com ' sed cgIRE�August 18.2017 1407)3%0153 (407i 338-0153 FloridallotaryServ;cexom City of Atlantic Beach II APPLICATION NUMBER Building Departmen o be assig�d by a Buil lg D rtme ) 800 Seminole Road Qp' ' Atlantic Beach, Florida 322:33-5445 \; f~ Phone(904)247-5826 Fax(904}247-5845 f017- , �; •�, City web-site: http://w\Arw.coab.us Date routed: / APPLICATION REVIEW AND TRACKING FORM /6�0 ( - Property Address: ee _Tient review required Yes o Applicant: g x Zoning rator Project: Public Vi orks Public U ':ties Public Safety Fire Servioes Review fee $ Dept Signature CONTRACTOR EMAIL ADDRESS CONTRACTOR CONTACT # APPLICATION STATUS Reviewing Department First Review: pproved. ❑Denie (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: d l TREE ADMIN. Second Review,: [-]Approved as revised. ❑De d. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date:-_ FIRE SERVICES ---- - Third Review, [-]Approved as revised. ❑Denie(,. Comments: Reviewed by: Date: REVISED 09252014 City of Atlantic Beach ( APPLICATION NUMBER To be assign d by a Buil Departme ) Building Department `� 800 Seminole Road / ,ate'` Atlantic Beach, Florida 322:33-5445 Phone(904)247-5826 • Fax(904)247-5845 017- "f a t�; City web-site: http://www.coab.us Date routed: S APPLICATION REVIEW AND TRACKING FORM OF Property Address: Jre ,:ent review required Yes No uild' L Applicant: nc Zoning E e ini5trator s 1 Public V. Ics Project: Public Us ties z Public S ;rety i Fire Serv_;as Review fee $ Dept Signature CONTRACTOR EMAIL ADDRESS i CONTRACTOR CONTACT # APPLICATION STATUS Reviewing Department First Review: NApproved. ❑Denie (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed Reviewed by: Date: 30 TREE ADMIN. Second Review: ❑Approved as revised. ❑Deniec PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: FIRE SERVICES - Third Review; ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: REVISED 09252014 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH D (� 800 Seminole Road, Atlantic Beach, FL 32233 l� Office (904) 247-5826 Fax(904) 247-5845 OCT 21 14 Job Address: �� 12- �ee Permit Nu �fr: Legal Description 1"Craa Parcel# --- Floor Area of S q.Ft. '�t Valuation of Work$�,o o� Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial Residential If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A Florida Product Approval# For multiple products use product approva orm Describe in detail the type of work to be performed: yA5:6 a (_ejav— e Property Owner Information: 1L t1' P� Name: VI 57b_" S r Address: )6,'q City A+Iaa r bea"ki State_ i )_3Z,;15_Phone 6`f- E-Mail or Fax#(Optional) Contractor Information: j� Company Name: IRAVAo c e Qualifying Agent: IJayd Address: 2 vt-o KAmift ?_41-64 4—a e- City J9,pA A r,, 7Ms lanW State Zip 3?o� Office Phone Isd- 1-94.11'11 Job Site/Contact Number Fax# State Certification/Registration# C CC 13 Z J 413 Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 constriction in this jurisdiction. This permit becomes null and void f work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a_peraod of six(6)months at arty time after work is commenced. 1 understand that separate permits must be secured for Electrical Work,Plumbing;Signs, Wells, Pools, urnaces,Boilers,Healers, Tanks and Air Conditioners,etc 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. I hereb certify that 1 have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this type q work will be complied withwhether s eci ted herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal,state, or lo aw regulating construction or the performance of construction. Signature of Ow • Signature of Conti for Print Name D1 1 1�• -:mA)50IJ Print Name d[�! .,.P. ............................................................................................................ �, Sworn to and subsc 'be before me Swornoand subscribed before me this l Day of 45tau 'PEYTON GU Day of 120 IjIDTON GUbllc MY COMMISSION#FF01664 Ota u 1CEXPIRES August 18,2017 R i (4 153 FloridallotarySenice.com X I u ust 18.201 - (407)39601530153 FloridallotarySeryice.com MAP OF BOUNDARY SURVEY DESCRIPTION: WEST HALF OF LOT 5 AND 5, BLOCK 43, ATLANTIC BEACH CORPORATION ACCORDING:TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 6, PAGE 1 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. CIL 12TH STREET 40' R/N .. B.L R.C_ 5/8" .. ... .... .. .. LB 7261 ..20'ASRW.1 FIRST COAST S89'32'28"E 62.50' A .. 1.. WEST 1/2 OF FIND ID�2 1 ^, LOT 6, BLOCK 43 e N N I COVERED 7.9' EAST;. 1OF LOT B. BLOCK 43 I 0 O 3 STORY o .,...Q.l.. ... BRICK STUCCO o W0 150 —J 20.1 o Zq Q ❑. O B o � w ❑� I voi BRICK ❑'^ Z U...'.. 15.1 EAST 1/2 OF 11116111 LOT 6, BLOCK 43 WEST 1/2 OF LOT 5. BLOCK 43 SEPTIC II NP 0.3' —J --A— N89'32'28"W 62.50' N 1 INO ID 2' S.IL6 7261/ 8 IFENCE 0.4' N FIRST COAST I LOT 4 BLOCK 43 SURVEY NOTES: /1 PLAT PROVIDES NO BEARINGS, THEREFORE BEARINGS ARE CERTIFIED TO AND FOR THE ASSUMED ON THE HEST LINE OF LOT 5 AND 6, BLOCK 34 FOR EXCLUSIVE BENEFIT OF: ANGLE DEFINITION ONLY BEING N00'00'00'E. CHANTAL G. HOOK /2 UNDERGROLM UTILITIES. FOUNDATIONS OR OTHER MELLS FARGO BANK. N.A. IMPROVEMENTS WERE NOT LOCATED BY THIS SURVEY. WESTCOR LAND TITLE INSURANCE COMPANY FIRST COAST T'TLE SERVICES. INC. /3 ACCORDING MAPTPANE Np 1200THE FEDERAL 75 0.MERGENCY MEFFECMTTIIVE 04/NT 17/69, THE PROPERTY DESCRIBED HEREON APPEARS TO LIE IN ZONE W. SWEET ADDRESS: /4 THIS 5U6MVEY PERFORMED NITHOUT BENEFIT OF AN ABSTRACT, 1 1501 STREET TITLE SEARCH, TITLE OPINION OR TITLE INSURANCE. ATLANTIC BEACH, FLORIDA /5 DIMENSIONS ARE SHOWN IN FEET AND DECIMALS THEREOF SCALE: 1" s 30 a AND ARE PLAT AND MEASURED UNLESS SHOWN OTHERWISE. mo /6 ALL EASEMENTS ARE PER PLAT UNLESS SHOWN OTHERNISE. 0 o /7 THERE MAY BE ADDITIONAL CANRESTRICTIONS D THAT APPLY WHICH ARE NOT SHOWN i ON THIS SURVEY WHICH CAN BE FOUND IN PUBLIC RECORDS OF SAID COUNTY. 0 o /B THIS SURVEY DOES NOT GUARANTEE ONNERSHIP. N /9 TEMPORARY, NON-PERMANENT IMPROVEMENTS AND/OR MAN-MADE ITEMS SUCH AS, BUT NOT LIMITED TO THE FOLLOWING: BUILDING MATERIAL. 'e7 0o STORAGE PODS. PAVER BLOCKS, RUBBERMAID OR PLASTIC UTILITY 0 BUILDINGS NOT ON FOUNDATIONS. VEHICLES VEHICLOR ES ON BLOCKS MAY BE ON RVR N w /10 LEGAL DESCRIPTION PROVIDED BY CLIENT. m NOTICE OF LIABILITY: THIS SURVEY IS CERTIFIED TO THOSE INDIVIDUALS PARTY ON THE FACE THEREOF. ANY OTHER USE BENEFIT OR RELIANCE BY ANY OTHER PARTY IS CLYDE 0. VAN KLEEC cSTRICTLY PROHIBITED AND RESTRICTED. SURVEYOR IS RESPONSIBLE ONLY TO THOSE FLORID REGISTERED SURVEYOR AND R NO. 2546 CERTIFIED ANO HEREBY OIBCLAIMS ANY OTHER LIABILITY AND HEREBY RESTRICTS THE R76NT5 DF ANY OTHER INOIVIWAL DR FIRM TO USE THIS SURVEY. WITHOUT EXPRESS NOT VALID NITHOUT THE SCGNATURE 6 OR RAISED ^y WRITTEN CONSENT OF THE SURVFYOR. SEAL OF A FLORIDA LICENSED S VEYOR A.MAPPER. a a' q -CHAIN LI ELECTRIC C::M: FIXMU CONCRETE MONU14EN7 C.M. -CONCRETE MONUMENT SEC -SECTION FEN -FENCE F.-CHAIN LIKK FENCE FOUND IAON ROD ANO CAP P.T. -POINT fH•TANGENCY MP-7 IP FNb _F M.F, -X000 FEN:E FO1Mm IROW A(MO P.C. -POINT OF CURVATURE ME- C.B -CIf01iD BEdRING F(lUNO IRON PIPE U.E. -UTITLITY EASEMEHM7 P.T.-�jH(TERSECTIDN (Pl -PLAT -MATER METER SET IRON ROD ANO CAP O.E. -DRAINAGE EASEMENT A/C -A �ON T _C EONCARETEE M.P. -�6�NEASUREO -FDUMO NAIL ANO DISK C 6 G -1CC6 GVTTFA X75-NOT E ESMT -EASEMENTP 6 N--FIELD MEASUREMENT R/N -RIGHTCONC OF NAY (PRH- LOR -COWER-CALCULATED NEASWENENT C/L -CENTERLINE E) -EXISTING LL FIELD 5 URVEY DATE PROJECT INFORMATION /. PLOT PLAN FIRST COAST LAND ORDER H,0.' 20003 iBOUNDARY 01,13.2010 SURVEYING, INC. DRAWN 8Y: TNP FORMBOARD 639-106 LANE AVENUE SOUTH. JACKSONVILLE, FL.32210 REVIEWED BY: TNP FOUNDATION PHONE (904) 779-2062 FAX (904) 779-7784 CHECKED BY: VAN LL CERTIFICATE NO. L8 7261 FINAL