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HomeMy WebLinkAboutBuilding Permit # 6/11/2015 IL IN PERMBU IT �,oR,H T NORTH A , ® APPLICATION FOR PLAN EXAMINATION Date Received �Ro�RRTEO PPp` G`� Permit iVo#: �SSAcwus�� Date Issued:IL IMPORTANT: Applicant must complete all items on this page I LOCATION � rint PROPERTY OWNER Print 100 Year Structure yes n MAP PARC ' µ,. ZONING DISTRICT: Historic District yes nom. lr Machine Shop Village yes jnjo- TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ne family ❑Addition ❑ Two or more family ❑ Industrial teration ,r No. of units: ❑ Commercial ❑ Repair, replacement D Assessory Bldg ❑ Others: ❑ Demolition ❑ Other «,rve gr",°i�81 aY�rrll° rear ��y�r���/"� t,/ f� �/ drar� ��l�„G7N�Sa'�MfrdVl✓tir<PrU�IP'1G� a !✓ y n�N F?��iGN��,I�J'Si"rl�}�f � � h rt u'�i� r /� ( �f�f- // DESCRIPTION OF WOR TO BE PERFOR, ED: OWNER: Name: L� Identification- Pease Type or Print Clearly r, d�� ,., . ., � J " -2, 1.'c' t Phone: �� � Address: _ ql=L r , Contractor Name: i Phone: ° '' w Email: � 4 . , Supervisor's Construction License: Irf. � Exp. Date: b Home Improvement License: A - Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ @ I FEE: $ a o -~' Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund , i / 101 moi', �i, ,� .fif���/��'✓ r✓lZi�rr/ /,r(ii7 i/ / /T/�'�/1/ �� ,,; -„ .- Version#46.2 '.' ,"SolarCity. �N OF Iy� June 1,2015 N Project/Job#0182044 RE: CERTIFICATION LETTER v iL 1 Q Project: b7bitson Residence Great Pond Rd �N�`��� North Andover, MA 01845 NAL 6/01/2015 To Whom It May Concern, A jobsite survey of the existing framing system was performed by a site survey team from SolarCity. Structural review was based on site observations and the design criteria listed below: Design Criteria: -Applicable Codes = MA Res. Code, 8th Edition,ASCE 7-05,and 2005 NDS - Risk Category= II -Wind Speed = 100 mph, Exposure Category C -Ground Snow Load = 50 psf - MP1: Roof DL= 13 psf, Roof LL/SL = 35 psf(Non-PV Areas), Roof LL/SL= 35 psf(PV Areas) Note: Per IBC 1613.1; Seismic check is not required because Ss = 0.33365 < 0.4g and Seismic Design Category(SDC) =C < D On the above referenced project,the components of the structural roof framing impacted by the installation of the PV assembly have been reviewed. After this review it has been determined that the existing structure is adequate to withstand the applicable roof dead load, PV assembly load,and live/snow loads indicated in the design criteria above. I certify that the structural roof framing and the new attachments that directly support the gravity loading and wind uplift loading from PV modules have been reviewed and determined to meet or exceed structural strength requirements of the MA Res. Code, 8th Edition. Please contact me with any questions or concerns regarding this project. Digitally signed by Nick Gordon Date:2015.06.01 09:21:11 -07'00' 3055 Clearview Way San Mateo, CA 94402 T(650)638-1028 (888)SOL-CITY F(650)638-1029 solarcity.com 06.01.2015 Version#46.2 PV System Structural SolarCl tY Design Software PROJECT INFORMATION &TABLE OF CONTENTS Project Name: Ibbitson Residence AH): North Andover Job Number: 0182044 Building Code: MA Res. Code,8th Edition Customer Name: Ibbitson,Caroline Based On: IRC;2009/IBC 2009 Address: 777 Great Pond Rd ASCE Code: ASCE 7-05 City/State: North Andover, MARisk Category: II Zip Code 01845 Upgrades Req'd? No Latitude/Longitude: 42.697515 1 -71.063270 Stamp Req'd? Yes SC Office: Wilmington PV Designer: Kyle Pecevich Certification Letter 1 Project Information,Table Of Contents, &Vicinity Map 2 Structure Analysis (Loading Summary and Member Check) 3 Hardware Design (PV System Assembly) 4 Note: Per IBC 1613.1; Seismic check is not required because Ss= 0.33365 < 0.4g and Seismic Design Category(SDC) = C< D 1 2-MILE VICINITY MAP 777 Great Pond Rd, North Andover, MA 01845 Latitude:42.697515,Longitude:-71.08327,Exposure Category: C STRUCTURE ANALYSIS LOADING SUMMARY AND MEMBER CHECK- MPI Member Properties Summary MPI Horizontal Member Spans Rafter Properties Overhang 3.41 ft Actual W 1.50" Roof System Properties San 1 6`.74 ft Actual D 5.50" Number of Spans w/o Overhang) 2 Span 2 7.32 ft Nominal Yes Roofing Material Comp Roof Span 3 A 8.25 in.^2 Re-Roof No Span 4 SX 7.56 in A3 Plywood Sheathing Yes San 5 IX 20.80 in.^4 Board Sheathing None Total Span 17.47 ft TL DefPn Limit 180 Vaulted Ceiling Yes PV 1 Start 3:08 ft Wood Species SPF Ceiling Finish 1/2"Gypsum Board PV 1 End 16.00 ft Wood Grade #2 Rafter Slope 120 PV 2 Start Fb 875 psi Rafter Spacing 16"O.C. PV 2 End F„ 135 psi Top Lat Bracing Full PV 3 Start E 1400000 psi Bot Lat Bracing Full PV 3 End Emb, 510000 psi Member Loading Summary, Roof Pitch 3/12 ", Initial Pitch Adjust Non-PV Areas PV Areas Roof Dead Load DL 13.0 psf x 1.02 13.3 psf 13.3 psf VV Dead Load PV-DL 3.0 psf x 1.02 3.1 psf Roof Live Load RLL 20.0 psf x 1.00 20.0 psf Live/Snow Load LL/SLhZ 50.0 psf x 0,7 i x 0.7 35.0 psf 35.0 psf Total Load(Governing LC I TL 1 48.3 psf 51.4 ncf Notes: 1. ps=Cs*pf;Cs-roof,Cs-pv per ASCE 7[Figure 7-2] 2. pf=0.7(Ce)(Q)(IS)p9; Ce=0.91 Q=1.11 I5=1.0 Member Design Summary(per NDS) Governing Load Comb CD CL + CL - CF Cr D+S 1.15 1,00 1 1.00 1 1.3 1.15 Member Analysis Results summary' Maximum Max Demand @ Location CapacitV DCR Load Combo Shear Stress 71 psi 3.4 ft. 155 psi 0.46 D+S Bending(+)Stress 483 psi 14.3 ft. 1504 psi 0.32 D+5 Bending (-) Stress -598 psi 3.4 ft. -1504 psi 0.40 D.i S Total Load'Deflection 0.09 in. I L/1001 14.0 ft. 0.5 in. I L/180 0.18 D+S CALCULATION OF;DESIGN WIND LOADS- MPI Mounting Plane Information Roofing Material Comp Roof PV iSystem Type SolarCity SleekMounVm Spanning Vents No Standoff(Attachment Hardware) Comp Mount Type C Roof Slope 120 Rafter Spacing 16"O.C. Framing Type/Direction Y-Y Rafters Purlin Spacing X-X Purlins Only NA Tile Reveal Tile Roofs Only NA Tile Attachment System Tile Roofs Only NA ,Standing Seam/Trap Spacing SM Seam Only NA Wind Design Criteria Wind Design Code ASCE 7-05 Wind Design Method Partaily/Fully Enclosed Method Basic Wind Speed V 100 mph Fig. 6-1 Exposure Category C Section 6.5.6.3 Roof Style Gable Roof Fig.6-116/C/D-14A/13 Mean Roof Height h 15 ft Section 6.2 Wind Pressure!Calculation'Coefficients Wind Pressure Exposure KZ 0.85 Table 6-3 Topographic Factor Kit 1.00 Section 6.5.7 Wind Directionality Factor Kd 0.85 Table 6-4 Importance Factor I 1.0 Table 6-1 Velocity Pressure qh qh= 0.00256(Kz)(Kzt)(Kd)(V^2)(I) Equation 6-15 18.5 psf Wind Pressure Ext. Pressure Coefficient U GC c -0.88 Fig.6-11B/C/D-14A/B Ext Pressure Coefficient(Down) GCo Down0.45 Fig.6-118/C/D-14Aj13 Design Wind Pressure p p =qh (GC) Equation 6-22 Wind Pressure Up Pwo) -16.2 psf' Wind Pressure Down a 10.0 psf ALLOWABLE STANDOFFSPACINGS X-Direction Y-Direction Max Allowable Standoff Spacing Landscape 64" 39" Max Allowable Cantilever Landscape 22" NA Standoff Configuration Landscape Staggered Max Standoff Tributary Area Trib 17 sf PV Assembly Dead Load W-PV 3.0 psf Net Wind Uplift at Standoff T actual -250 lbs Uplift Capacity of Standoff T-allow 500 lbs Standoff Demand Ca aci DCR 50.0% X-Direction Y-Direction Max Allowable Standoff Spacing Portrait 32" 65" Max Allowable Cantilever Portrait' 13" NA Standoff Configuration Portrait Staggered Max Standoff Tributary Area Trib 14 sf PV Assembly Dead Load W-PV 3.0 psf Net Wind Uplift at Standoff T-actual -208 lbs Uplift Capacity of Standoff T-allow 500 lbs Standoff Demand Ca aci DCR 41.6% DocuSign Envelope ID:27B9370D-A085-4AFD-8D08-3CCB5FFEBBAB r ® Power Purchase Agreement Here are the key terms of your SolarCity Power Purchase Agreement Date: 5/20/2015 $0 12 .,000 20years System installation cost Electricity rate perk h Agreement terra Our Promises to You ® We insure,maintain,and repair the System(including the inverter)at no additional cost to you,as specified in the agreement. ® We provide 2417 web-enabled monitoring at no additional cost to you,as specified in the agreement. ® We warranty your roof against leaks and restore your roof at the end of the agreement,as specified in the agreement. ® The rate you pay for electricity,exclusive of taxes,will never increase by more than 2.90%per year. ® The pricing in this PPA is valid for 30 days after 5/20/2015.' ® We are confident that we deliver excellent value and customer service.As a result, you are free to cancel anytime at no charge prior to construction on your home. Estimated First Year Production 12,182 kWh Customer's Name & Service Address Exactly as it appears on the utility.bill Customer Name and Address Customer Name Installation Location Caroline Ibbitson David Ibbitson 777 Great Pond Rd 777 Great Pond Rd North Andover, MAS 01845 North Andover, MA 01845 Options for System purchase and transfer: Options at the end of the 20 year term: ® If you move,you may transfer this agreement to the purchaser of your ® SolarCity will remove the System at no cost to you. Home,as specified in the agreement. ® You can upgrade to a new System with the latest solar ® At certain times,as specified in the agreement,you may purchase the technology under a new contract. System. ® You may purchase the System from SolarCity for its fair ® These options apply during the 20 year term of our agreement and not market value as specified in the agreement. beyond that term. . You may renew this agreement for up to ten(10)years in two(2)five(5)year increments. 3055 CLEARVIEW WAY, SAN MATEO, CA 94402 888.SOL.CITY 1888.765.2489 I SOLARCITY.COM MA HIC 168572/EL-1136MR Document Generated on 5/2012015 0'�❑� 788787 ❑� DocuSign Envelope ID:27B9370D-A085-4AFD-8D08-3CCB5FFEBBAB 23. NOTICE OF RIGHT TO CANCEL. I have read this Power Purchase Agreement and the Exhibits in their YOU MAY CANCEL THIS CONTRACT AT ANY TIME PRIOR TO entirety and I acknowledge that I have received a complete copy of this MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE Power Purchase Agreement. YOU SIGN THIS CONTRACT. SEE EXHIBIT 1,THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN Customer's Name:Caroline Ibbitson EXPLANATION OF THIS RIGHT. EA;b signed by: 24.ADDITIONAL RIGHTS TO CANCEL. Signature: UtA.t, J��al66VU IN ADDITION TO ANY RIGHTS YOU MAY HAVE TO CANCEL THIS PPA UNDER SECTION 23,YOU MAY ALSO CANCEL Date: 5/20/2015 THIS PPA AT NO COST AT ANY TIME PRIOR TO COMMENCEMENT OF CONSTRUCTION ON YOUR HOME. 25. Pricing The pricing in this PPA is valid for 30 days after 5/20/2015. If you Customer's Name: David Ibbitson Sig Docuned by: don't sign this PPA and return it to us on or prior to 30 days after I �hl�ifSblA. 5/20/2015,SolarCity reserves the right to reject this PPA unless Signature: you agree to our then current pricing. Date: 5/20/2015 .,' olarCity, Power Purchase Agreement SOLARCITY APPROVED Signature: LYNDON HIVE, CFO (PPA) Power Purchase Agreement t rCft' Date: 5/20/2015 ❑` ❑� Solar Power Purchase Agreement version 8.4.1 788787 �i ' The Cominiurrwealth ofMassaclirisetts .Deparinient of IndirsirklAct:idents Office ofInuestigadons ' 1 Congress Street?,Steffe 1110 Boston,AVM 02114 20M WfVw.niass.goV1dia Workers'Compensation Insurance Affidavit;Builders/Contractors/Blectricians/Piumbers AnDficant Information Please Print Le Nanrre(lausinc55/Orguizatictn/individual): SolaEg.t COr Address, 3055 Clearview Way City/StateM : 402 Phone#, 8.88-765-248 Are you an employer?Chetlt the appropriate box: 1,E]I am a employer with 4• [] I am a gwicral contractor and I Type of project(required); ernglayces(felt andloxpart-titre),* have Ititd the sub co�tttctors El Now construction2.E3 am a sole proprietor or partner- listed as the attached sbeet. 7. 0 Remodeling ship and have no empIoyeos These sub-contractors have 8. (]Demolition working forme in any capacity, employees and have workers' g, []Building addition [No workers' Comp, insurance camp,insurance. required.] 5- We are a corporation and its 10.D Electrical repairs or additions 3.[:11 am a heincowlxer doing all work officers have exercised their I I,E)Plumbing repairs or additions Myself. [No workers' comp, right of cxemptior,p$r IvIGI, 12.© hoof repairs insurance required)t c. 152,§1(4),and we have no employees.[No workers' 13D other comp. insurance required,] *tiny appbi altt that checks box#1 most also tilt out the scalier Ba1aw showing!heir workers'eompcaaatian ptsltcy fafomtatian. t t-romeownets wha submit this affidavit indicating Mry are doing an work and then hiry outsi&oannuctoxs must submit a new affidavit indicatingsuch, :Comraaterg that check chis box must attached tut additional sheetshowing wa name oftho sub-contractors and state whether or not thosecmuics have amployees. if the sub-contractus have employ=s,lhcy trust provide their wotkeis'comp.pahuy number. 1 erre:an employer that isprauirll�zg tpntkers'compensation husunnieefor my eniployees. fielow is the policy and}oh site information. Insurance Company Name: Liberty Mutual Insurance Co Policy#or Seltrins.[,ic,HMA766DO0026, 5024 Expiration Date; 9/1/15 Job Site Addresz. j r City/state/zip; ��� � (r� Ine- Attach a copyof the workers,compenv2tion paliey doclnrativr,page(showing flue policy number and expiration date). Nifure w secure coverage asrcquired under Section 25A of MGT.c, 152 can lead to the imposition of o6minal penalties of a fine up to$1,500.00 andlor one-year imprisonment, ag tweil as civil penalties in the forth of a STOP WORK ORDER and a fine of up to$250,00-a day against the violator, Be advised that a copy of this statement may be forwarded to the Office of investigations of the DIA for insurmce coverage verificaticm. I do hereby certify i z the pants and penalties ofperjur that elle ittfornttttlon provitla/d ttbnue is tette and correct. Si aturc: :�17ate: YJ phorF= . 0fjtcltzl-'se vztiJ> Leo not write in this area,to be completed by city or tower ofciat City or Tot.mt; FermidLieeose# Issuing Authority(circle 011v): 1.,Board of 9calth, 2.Building Department 3.Cityffowu Clerk 4.Mt etrical InSpectur 5.Plumbing Inspector f. ther Contact Person, Phone#: ERj A I) ICATE O LI/'ltBILI ■Y INSURANCE^ DATE(MRVI7i77YYYY) C 1)&29y201A rRis GaF2Tf1+1CATE Is ISSUED AS A MATTER OF INFORMATION ONLY AND CONFMS NO R14HTS UPON T14E CERTIFICATE HOt MR, THIS ceitTFFICATE DOES NOT AFFIRMATIVELY Clic NMATIVELY ABAEND+ R_XT'END Oft ALTER THE COVI«RAGE AFFORDED BY THE OUED I ES MULOW. TWS CVRYMCATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT' RVWEEN 71-18 iSSUINCs INSURER(S), AU F REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE tfOWER. Im_P RTANT: tf the certENcate holdtr Is 8n AUD TEONAL.IRURED,thR poliay(las)must Im endolmad. if S;ueF->awrioN is WAIVEb,ttublact to the tens attd eonditIonu of the policy,certain policies may taquire an antimement, A stateroom on this cartiticate does not confer tights to the ceruticate halter in lieu of such crLdomement(ea. PRdDUCCn H ... _ ..�.•. . -- __ .... mWSi RISK AI INSURANCE SERVICES pubRi FA 34s CALIFORNIA STRF-ET,SURE 13M Vic,r. CALIFOgNA LICENSEN0.0417153 SANFRANCISCO,CA &11104 INSU�iE{Ilei AfFoltRWdCOVERAGE NASCq 99g301•STND-GkYN)E s4 15 1"'URERA:U-YM Vito 1n5urandaCotrpsny lti5$8 LibedyInsufWacarparaw INSURED ... - ... /2404 Ph(650)863.5100 #NSUR13t8:IPA iWA sibralyCM014Gon INsurtmc... . M55 MW&W Way INSURER D.t - San Matto,CA M402 INattaart r- tNsua>_ COVERAtaES CERTIFICATE NUMBER- REVISTON NUMBER:4 THIS IS To CCWiFY TRW•fill:t'OLICIHS OF INSURANCE LISTED HEI-OW HAVE BERN ISSUED TO THE INSURE✓O NAMED ABOVE FOR THE POLICY PERIOD mOICATED. NaTWITHSTANDING ANY REQUEREMENT, TERM OR CONDITION OF ANY CaN7RACT OR EITHER DOCUI gMy 4111T14 RESPECT TO ik"ICH THES CERTIFICATE MAY BE tSSUFO OR MAY PE"ATAIN.TELE INSURANCE AFFORQI~D BY THE POLICIes OgSCRiSED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LiMITS SHOVm NAAY HAVE SEEN REDUCED BAY PAID-CLAW._ APiJdy kfF tr Pt>I-ICY 681 a TypEpPQFBtfRAttbi! a NUJdaa ttrnlxtYw I $ 1000Ath1 A 'c NSRALuaaultY TU26S3-R3 6"1d "1121134 0J01t20t5 OACHDOWRRtNU s E3iWAWioARi Citi A 100,06 X GO►,W51tC1AL GENERAL UAKLITl r#AIIAS tdADC ; X I OCCUR I t taco ExP EAny«aPerson)_ ,s 10,000 # I � �I'a=s7G8turit-t�AtWINJURY IS 3.000UOD � � � I GENESIAL AGGREGATE {f 2,000,OIXI x { RLoc I A52.6G1•ElG020SG1d t5 :P$fO4RDIbUYCitTf3_JU• RCYOEM�PI�CpIP�AGGI GEN_ACCRCGRTF:LIMIT APPLIES PER MUt POLICY G IAE4900 N e LIMIT A AU )MOLIABILITY 0011241140120 X-AAFjdant} SS .. tz.•,.0. .025. .••fl0�0 I K AHYAIN-6 3� f l 801mv INJURY IPmracudam)i AUTOS, I WIDE PROPERTV UAAVIGE X tNDNOWNdAt % IYR£OA1TOS y AUTRS X (Phys Damage CAfdP1C0L1Dl11; s SiS?001ii000 F114 OWLIALIAB I t}CCiNt j EItCHOCCURRENCr 6 1!?w!98 ILIAD I OLAhrS•MADE E AGGREG4f£ S DL J,rTETeNn S g itto"ERSCOMPEttSATwN lfA7 S 65 024 I)gh3tt20t4 Of11035 T.48YLIA6S Tti. IER' : Alto kPLOYERLEA&ILttY 4tC7S630Gf• 1y 0rYii17015 SRCN1s£L!%0.ACB ANY PROP141MR AYNEV00C 0,800,000 000 0TfMrRf4PMBEFt 15XCtUDEW '}^' t. 1 A NX DfDUCTIR!E:WOW W'' E L DISEASE•CA EMPLOY a am) CC�5 j�' Itdsttdatory In E L UUEA6E•PO tcY LUdTK i u H rlasalb6 unt!e1 D CRIP'! PPAATtDNSbobw . j l - 1 agaC RIpIM Of OPERATIONS I LOGATWNS i VEHICLO(Attach Acorto A41,Addittantt Rent Sanddutn,l11 r4art eptlee Is Fe0frorl) Eptleme 6f h9oholtte. CIL IFIQA-rE14OLDER CANCELLATIO W&CIty Corpw(IQP SIEOULD ANY OF THE ABOVE paSGRIBEt)POLICIES 09+CAFICELLJs D BEFORE v55Me4tv#ewWay THE EXPlcii.;1ON 0= 1RCI GC>F, f34TICE WILL BE BSL!:'`I' -4 San matee,CA M402 ACCORDANCE WM THIE POLICY PROVISIONS- Charles NIMM019.10 ROVISIONS.CharleslIMM01e;0 1898.2010 ACOFM CORPORATIt7N. All ilgro reserved, ACOAD 26(2010405) The ACORR name and logo ars regiMered ma"of ACORi3 s � re ��P` ind Office off'Consumert (fairs Business Regulation ry �14 y 10 dark Placa - Suite 5170 qe; Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 168572 Type: Supplement Card Expiration: 3/8/2017 SOLAR CITY CORPORATION JAYMIE STANTON 24 ST MARTIN STREET BLD 2UNIT 11 MARLBOROUGH, MA 01752 - - - _ --- ----...... -- Update Address and return card.Mark reason for change. Address [—� Renewal 1-1 Employment F] host Card SCA 1 r: 20M-05 Ifi lice of Consumer Affairs&Business Regulation License or registration valid for individul use only E IMPROVEMENT CONTRACTOR before the expiration date. 1f found return to: Office of Consumer Affairs and Business Regulation z ,registration: 168572 Type: 11)Park Plaza-Suite 4190 Expiration: 3/8/2017 Supplement Card Boston,MA 02116 SOLAR CITY CORPORATION JAYMIE STANTON 3055 CLEARVIEW WAY N _,._....__ k. SAN MATEO-,CA 94402 Undersecretary V- tlid without signature ---------- Office Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 168572 Type: Supplement Card SOLAR CITY CORPORATION Expiration: 3/812017 DAN FONZI - ----_- -.- -----_.__- 24 ST MARTIN STREET BLD 2UNIT 11 MARLBOROUGH, MA 01752 Update Address and return card.(Mark reason for change. ❑ Address � Renewal [7 Employment :_ Lost Card (}t'fice of Consumer Affairs&Business Regulation License or registration valid for individul use only SME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: (Office of Consumer Affairs and Business Regulation Registration: 168572 Type: 10 Park Plaza-Suite 5170 Expiration: 318/2017 Supplement Cerd Boston,MA 02116 SOLAR CITY CORPORATION DAN FONZ€ 3055 CLEARV€EW WAY .,t- e --• - SAN MATEO,CA 84402 Undersecretary Not valid without signature CS-7D7687 DANIELD F®NZI; 2 15 KELLEY RIO W GTON KA 01 09173/2016