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EL-18-1505 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 !Inspection Number: INSP-307122 Permit Number. EL-6-18-1505 Scheduled Inspection Date:June 26,2018 Permit Type: Electrical- Residential Inspector: Devaney,Michael Inspection Type: Final Owner: Work Classification: Service Change Job Address:510 NW 113 Street Miami Shores,FL 33168- Phone Number Parcel Number 3021360210870 Project: <NONE> Contractor. _ EVOLUTION ELECTRICAL CONTRACTORS Phone: (786)351-5784 Building Department Comments Infractio Passed Comments SERVICE CHANGE INSPECTOR COMMENTS False s r i Inspector Comm Passed Ef Failed Correction Needed Re-Inspection Fee a No Additional Inspections can be scheduled until re-inspection fee is paid I June 25,2018 For Inspections please call: (305)762.4949 Page 42 of 42 i Permitn/o. EL-6-18-1505 sw°Rus y�� Miami Shores Village Permit Type:Electrical -Residential 10050 N.E.2nd Avenue NW ', I ' work Clc3SSJt!Cs'ft1QR:SerVtCt3 C11"dng8 �- Miami Shores,FL 33138-0000 Permit Status:APPROVED I 1FB "a` Phone: (305)795-2204 f/v �N 0 �'toRty� Issue Date:6/1312111$ Expiration: 12/10/2018 Project Address Parcel Number Applicant 510 NW 113 Street 3021360210870 SMTKLLC Miami Shores, FL 33168- Block: Lot: Owner Information Address Phone Cell STKLLC PO BOX 7997 PORT ST LUCIE FL 34986- PO BOX 7997 PORT ST LUCIE FL 34986- Contractor(s) Phone Cell Phone Valuation: $ 2,000.00 EVOLUTION ELECTRICAL CONTRAC i (786)351-5784 Total Sq Feet: p Type of Work:SERVICE CHANGE Available Inspections: Additional Info:SERVICE CHANGE Inspection Type: Classification: Residential Review Electrical Scanning: 1 Review Electrical t Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# EL-6-18-67774 DBPR Fee $2.25 06/01/2018 Credit Card $50.00 $ 110.45 DCA Fee $2.00 Education Surcharge $0.40 06/13/2018 Credit Card $ 110.45 $0.00 Permit Fee-Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $1.60 Total: $160.45 i_ 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, LIMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVI certify t e foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and z i Fu a or horize the above amed contractor t do the work stated. June 13, 2018 uthori ed Signature:O ner / Applicant / Contractor / Agent Date Building Department Copy June 13,2018 1 , j Miami Shores Village ,. � JllN -41 201 . �f oic tia Building Department 10050 N.E.2nd,Avenue,Miami Shores, Florida 33138 \� Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 le FBC 2011 BUILDING Master Permit NoFL 1 S- IS0 S PERMIT APPLICATION Sub Permit No. ❑BUILDING dELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑SHOP CONTRACTOR DRAWINGS JOB ADDRESS:._510 W 11 . ST City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: '!I I&-0'21 s 08-10 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): SAN 7V__ LLC_ Phone#: Address: 2: Ll 6 SE E_AC^.LE t�Q\V F- City: '{ Q"T 5C LX\E State: LOR\\JPtZip: 3LAQI�LI Tenant/Lessee Name: Phone#: L-IOs 5fa Cab(l Email:- CONTRACTOR:Company Name: 411�Ll()X r'Orr aeC7�4 to 4::�O WT- Phone#: _f 12�CD 35-/ -5:�P8 Address: //K 3/ AAr" p L/�8 4 City: " i g/r—.9W State: L(JV k/0 A Zip; 330/Z Qualifier Name: '4"W10 z4eAA-1 A Phone#: State Certification or Registration#: Certificate of Competency#: 1667 d 0 0 6/0 DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 2 0 0 a Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: P i V*'o=P� Gln A vNg _ , Specify color of color thru tile: Submittal Fee 450 Permit Fee$ _ ®�� CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ __ TOTAL FEE NOW DUE$ (Revised02/24/2014) Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City 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. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,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. SignatureZ�4�a, Signature P.Q'V0r4l0 c4sTr' OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before finepthis The foregoing instrument was acknowledged before me this day of 20 / 0 by 7 day of A a'� .20 \Q) by 1-bC A C, ?r j A W .who is personally known to IN li i o taJ 1 D A c c a A ,who is personally known to me or who has produced J i.L c�.�-e as me or who has produced as identification and who did take an oath- I identification and who did take an oath. ' P„e SUSELhERNANDEZ NOTARY PUBLIC. Y .,� NOTARY PUBLIC: ��•; Notary Public-State of Florida R. Commission# GG 015538 ,+� o;: My mm.Expires Jul 25,2020 Sig F�,•`' r u h National Notary Assn. Sign: Print� Print: �0" Notary Public State of Florida My Commission GG 195698 Seal: Seal: �. Expires 04/06/2022 1 *ss*s**ssssssss*s*ssssss***sssss**sssssss**s*ss**ssss*****s*******ssssss*s*ss*sssssssssssssssssssssss*s*ssss APPROVED BYE /1rGN1B Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Property Search Application - Miami-Dade County Page 1 of 1 OFFICE OF THE PROPERTY APPRAISER �. Summary Report Generated On:5/30/2018 Property Information :. Folio: 11-2136-021-0870 „• 4 # r 510 NW 113 ST Property Address: .� Miami Shores,FL 33168-3321 q Owner SAMTK LLC _ PO BOX 7997 Mailing Address t PORT ST LUCIE, FL 34986 USA PA Primary Zone 5700 DUPLEXES-GENERAL " 0802 MULTIFAMILY 2-9 UNITS:2 Primary Land Use LIVING UNITS Beds/Baths/Half 4/2/0 �, a Floors Living Units 2 Actual Area Sq.Ft i to by Living Area Sq.Ft Adjusted Area 2,174 Sq.Ft Taxable Value Information Lot Size 8,178 Sq.Ft 2017! 2016' 2015 Year Built 1953 - - County Assessment Information Exemption Value $0 $0 $0 Year 2017 2016 2015 Taxable Value i $191,752 $174,320 $167,070 Land Value $92,041 $36,696 $36,696 School Board Building Value $137,530 $137,624 $137,717 Exemption Value $0 $0 $0 ___...................._........................ w XF Value $0 $0 $0 Taxable Value $229,571 $174,320 $174,413 —...................._... ._ . __... ..... __ _.._ _.... Market Value $229,571P$:l::7:4,320: $174,413 City ........................_. .........._.... Exemption Value $0 $0 $0 Assessed Value $191,752174,320, $167,070 Taxable Value $191,752 $174,320 $167,070 Benefits Information Regional Benefit Type 2017 2016" 2015 Exemption Value $0 $0 $0 ......... ............_. Non-Homestead Cap lAssessment Reduction $37,819 $7,343 Taxable Value $191,752 $174,320 $167,070 Note:Not all benefits are applicable to all Taxable Values(i.e.County, School Board,City, Regional). Sales Information Previous OR Book- Short Legal Description Sale Price Page Qualification Description WEST SHORES PB 42-18 _ 12/28/2012 $100 28420-1237 Corrective,tax or QCD;min LOT 9 BLK 5 consideration .................. LOT SIZE 58.000 X 141 11/13/2009 $100 27104-2343 Financial inst or"In Lieu ofForclosure"stated OR 16113-2439 1093 4 _._... _.___.. _ _..... .............. ... 07/01/2007 $250,000 25759-1665 Sales which are qualified COC 24605-0057 06 2006 4 The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at http://www.miamidade.gov/info/disclaimer.asp Version: https://www.miamidade.gov/propertysearch/ 5/30/2018 Detail by Entity Name Page 1 of 2 Florida Department of State C,ivuaiou or Cora or.rrr:,Ns 1 Department of State / Division of Corporations I Search Rftc2.rds / Detail By Document Number/ Detail by Entity Name Florida Limited Liability Company SAMTK, LLC Filinq Information Document Number L12000080746 FEI/EIN Number 65-1193553 Date Filed 06/19/2012 Effective Date 06/20/2012 I State FL Status ACTIVE Last Event REINSTATEMENT € Event Date Filed 11/22/2017 Principal Address 2746 SE EAGLE DR PORT ST LUCIE, FL 34984 Mailing Address PO BOX 7997 PORT SAINT LUCIE, FL 34985 Registered Agent Name&Address SAMMULI, LYNN A 2746 SE EAGLE DR PORT ST LUCIE, FL 34984 Name Changed: 11/22/2017 Authorized Person(s)Detail i Name&Address Title MGR SAMMULI, LYNN 2746 SE EAGLE DR PORT ST LUCIE, FL 34984 Annual Reports Report Year Filed Date 2016 03/24/2016 2017 11/22/2017 2018 04/29/2018 http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 5/30/2018 -- �j V 0/U Y,?0/J Ie c -(f;G A COtJ Company letter Head Date { State of Florida County of Miami-Dade Before me this day personally appeared A t�To N'%o A c n ST A Who, being duly sworn,deposes and say: That he or she will be the only person working on the project at: .51,0 Nvk 113T16, 5-r- r M,AM, SL,��>°_�T_ 331 l"A Contractor Sign ture Sworn to(or Affir d)and subscribed before me this,LL day of a� 2018, By Personally know �4 Or Produced Identification Type of Identification Produced Notary Public State of Florida Isis M Paez My Commission GG 195698 a A Expires 04/06/2022 Print,Type or Stamp Name of Notary 1 5"°'9s y r s� Miami shores Village "' Building Department artment "'Es ° 10050 N.E.2nd Avenue F�ORIDP' Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner - Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers'Compensation Employer Facts Brochure: f An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers'compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation,or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers'compensation exemption and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of workers'compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature:Pa4,z KBhtd C,t„�yG Owner State of Florida { County of Miami-Dade The foregoing was acknowledge before me this day of u h ,20 By 14 { Ha4pl 2a e Z who is personally known to me or has produced (—(fe a zi s J as identification. Notary: .SEAL: ,4�,pr Pfie•. SUS HERNAN,tL Nota y ublit-State of Florida •= Commission S „G 015538 My Comm.Exp*Feis jul 25,2020 �•'''°� Bonded thro.jn National Notary Assn. Original in Safekeeping with McCarthy,Summers,Bobko,Wood, Norman,Bass&Melby,P.A. Attorneys at Law 2400 SE Federal Hwy.,Fourth Floor DURABLE POWER OF ATTORNEY Stuart,FL 34994 FOR LYNN A. SAMMULI 0 py. CI;LYNN A:SAMMULI,as of November 13,2017,hereby appoint and empower my step- daughter;DEBRA KOMO_CIPRIANI,as my true and lawful attorney-in'fact("my Agent"),to act for me and in my name and on my behalf to exercise the powers listed in this Durable Power of Attorney. Third Parties. Any third party to whom this Durable Power of Attorney is presented may rely upon an affidavit by my Agent stating, to the best of my Agent's knowledge and belief, that this power has not been revoked,that I am then living,and that no proceedings have been initiated to determine my incapacity. A THIRD PARTY WHO IMPROPERLY REFUSES TO ACCEPT THIS POWER OF ATTORNEY WILL BE LIABLE FOR DAMAGES, INCLUDING REASONABLE ATTORNEY FEES AND COSTS, INCURRED IN ANY ACTION OR PROCEEDING THAT CONFIRMS THE VALIDITY OF THIS POWER OF ATTORNEY. Durable Power. This Durable Power of Attorney will not be affected by my subsequent incapacity except as provided in Chapter 709 of the Florida Statutes. It is my specific intent that the power conferred on my Agent will be exercisable from the date of this Durable Power of Attorney, and will remain effective thereafter, notwithstanding my subsequent disability or incapacity,except as otherwise specifically provided by statute. t My Agent will have the following powers and duties: GENERAL AUTHORITY 1. To manage all assets and properties belonging to me or in which I have any interest, and f to expend whatever funds my Agent deems proper for the preservation, maintenance, or improvement of those assets or properties. 2. To exercise all powers even though my Agent may also be acting individually or on behalf of any other person or entity interested in the same matters (as more fully set..forth in the Additional Provisions section). I 3. To seek on my behalf the assistance of a court or other governmental agency to carry out an act authorized in this power of attorney and to enforce the exercise of these powers granted to my Agent. 4. To exercise any authority reasonably necessary to give effect to an express grant of specific authority in this power of attorney. 5. To the extent not limited under the law of the jurisdiction in which this power of attorney is presented, to take all other actions as may be necessary or appropriate for my personal well-being and the management of my affairs,as fully and as effectively as if made or done by me personally. SPECIFIC POWERS 1 � 6. To manage and conserve any real property,or any interest or incidents in real property,on my behalf, including the authority to receive, buy, sell, exchange, lease, encumber, and convey such property. Such property and incidents in property include any interest in homestead property, mineral rights, cooperative apartments, and any property I own as joint tenants with right of survivorship or as tenants by the entireties. 7. To manage and conserve any tangible personalproperty,or any interest in tangible personal property,including exempt property,on my behalf,including the authority to receive,buy, sell,exchange, lease, encumber,and convey such'property. 8. To operate, insure, license and register with any state or government agency, any and all vehicles of which I am the registered or legal owner. 9. To conduct investment transactions as provided in Fla. Stat. §709.2208(2). 10. To collect, receive, and receipt for any and all sums of money or payments due or to become due to me. 11. To pay any and all bills, accounts, claims, and demands now or hereafter payable by me, including a judgment, award, order or settlement made in connection with a claim or litigation. i 12. To conduct banking transactions as provided in Fla. Stat. §709.2208(1). 13. Except as otherwise provided under Fla. Stat. §709.2201(3) relating to contracts for personal services,to contract with any person or Entity for any purpose(including contracts between me and my Agent), and to perform that contract; to agree to any termination, release, rescission or modification of any contract or agreement. j 14. To the extent not limited in the Special Transactions section, to act for me regarding any trust,probate estate,guardianship,conservatorship,escrow,custodianship or fund in which I may have a right or beneficial interest, including the power to transfer property to the trustee of a trust created by me or for my benefit. 15. To sue in my name and behalf for the recovery of any and all sums of money or other things of value,payments due or to become due to me,or damages I have sustained or will sustain; to seek an attachment, garnishment, order of arrest, or other preliminary, provisional, or intermediate relief and use an available procedure to effect or satisfy a judgment, order, or decree;and to collect,hold and disburse any property received in satisfaction of judgments. 2 16. To act for me with respect to any bankruptcy.or insolvency concerning me or some other person,or with respect to a reorganization or receivership which affects my interest in any property. 17. To demand, obtain, review, and release to others medical records, documents, or communications protected by the patient-physician privilege, attorney-client privilege, or any similar privilege, including all records subject to, and protected by, the Health Insurance Portability and Accountability Act of 1996, as amended ("HIPAA"). I designate my Agent as my personal representative under HIPAA. My Agent may also enforce any or all of the privileges listed above. 18. To nominate on my behalf a}person (including an Agent) or entity to be appointed by a court of appropriate jurisdiction as guardian of my person or property, or both, or as custodian for my property during the pendency of any proceedings to determine my legal capacity. 19. To receive and open my mail, change my mailing address, and otherwise represent me in any matter concerning the U.S. Postal Service. k 20. To hire and compensate attorneys,accountants, advisors, financial consultants, managers, agents,and assistants(including any individual or entity who provides investment advisory or management services, or who furnishes professional assistance in making investments) without liability for any act of those persons, if they are selected and retained with k reasonable care. An Agent may serve in one or more of these capacities and be compensated separately for the services in each. 21. To discharge (with or without cause) any person hired by me (or on my behalf), by my Agent,or by any prior Agent,including but not limited to,the categories of persons named above,and physicians, nurses, care-givers,and domestics. 22. To act for me with respect to benefits or actions from or relating to any branch or department of the United States government, any state government, or any foreign government,whether or not recognized by the United States, including without limitation, the Social Security Administration, the Department of Veterans Affairs, the `Internal Revenue Service, Medicare or Medicaid, and any government department providing payments or grants. 23. To create,fund,and maintain an Income Trust pursuant to 42 USC §1396(d)(4)(B)in order to qualify me or retain my eligibility for Medicaid or any other public assistance benefits. 24. To represent me before any office of the Internal Revenue Service or any state agency; to receive confidential information,regarding all tax matters (for my SSN ending in -2669) for all periods, whether before or after the execution of this instrument; to prepare, sign and file any tax return on my behalf;to pay taxes due,collect refunds, post bonds,receive confidential information, and contest assessments, deficiencies, fines, or penalties determined by the Internal Revenue Service or any other taxing authority;and to make any tax elections on my behalf 3 9 e . 1 25. As provided in and in furtherance of the Florida Fiduciary Access to Digital Assets Act ("FFADAA"), to access and control communications intended for me, and communicate on my behalf, whether by mail, electronic transmission, telephone, or other means; to access and control all of my accounts involving web-based communications or storage and web-hosted media, including but not limited to emails, messages, blogs, subscriptions, pictures, videos, e-books, audiobooks, memberships in organizations or commercial enterprises, and all forms of social media, whether or not those require a user name and password for access,even to the extent of compelling the provider to reset my information to data of my Agent's choosing,all in keeping with the Electronic Communications Privacy Act of 1986, the Computer Fraud and Abuse Act of 1986, and FFADAA, as those may be amended; and to hold, control, and have access to and the use of any digital asset (as defined in FFADAA)held by any kind of computing or digital storage device or service. } SPECIAL TRANSACTIONS Certain transactions under this power of attorney may profoundly affect my existing estate plan and therefore require a separate authorization for my Agent to engage in them. By initialing next to the term "Yes" for any items within the respective numbered paragraphs in this, Special Transactions section, I grant my Agent the authority stated in that paragraph with respect to the item so initialed. If I have not initialed an item by the term"Yes", my Agent is not authorized to take that action. 26. Yes No Gifts. I authorize my Agent to make gifts of my property outright to,or for the benefit of,DIANA KOMO HALL, DEBRA KOMO CIPRIANI, and their descendants, including for the benefit of my Agent (if my agent is a descendant), in an amount per donee each calendar year"not to exceed the annual dollar limits of the federal gift tax exclusion under Internal Revenue Code §2503(b)(annual exclusion),together with any amounts qualifying for federal gift tax exclusion under Internal Revenue Code §2503(e) (medical and educational exclusions). For these purposes, a gift"for the benefit of a person includes a gift to a trust in which that person is a beneficiary, to a custodial account under a state version of the Uniform Transfers (or Gifts) to Minors Act,'and to a tuition savings account or prepaid tuition plan as defined under Internal Revenue Code §529. 27. Yes No Trusts. I authorize my Agent to create an inter vivos trust, whether revocable or irrevocable, in which I am a beneficiary; to the extent the trust instrument specifically provides for the exercise of such authority by the settlor's agent,to amend, revoke,or terminate a trust of which I am a beneficiary, or transfer the assets of such a trust into another trust under which I am a beneficiary;to create, amend, or revoke trusts for the benefit of others, including for the benefit of my Agent; and to participate in ' either j cial or nonjudicial modification of a trust as permitted in Fla. Stat. Chapter 736. 28. Yes No Survivorship and Other Designations. I authorize my Agent to create or change rights of survivorship in accounts or other assets in which I have 4 , 1 , 1 an interest, including for the benefit of my Agent; to change a beneficiary designation for r any accounts or financial instruments, including life insurance policies, annuities, or retirement accounts of any nature; and to waive my right to be a beneficiary of a joint and survivor annuity, including a survivor benefit under a retirement plan of any nature. 29. Yes No Disclaimers. I authorize my Agent to disclaim: any interest in property I might otherwise receive, either outright or in trust, including for the benefit of my Agent; any powers I have over property or as a beneficiary of any trusts (excluding any powers I possess in a fiduciary capacity); and any powers of appointment I have or may acquire, excluding any testamentary power of appointment that I currently a exercise in my Last Will and Testament. INSURANCE,ANNUITIES,AND RETIREMENT FUNDS 30. For purposes of this section, a "Contract" means a contract of insurance on my life, a contract of insurance regarding my disability or long term care, or an annuity (however denominated). A "Plan" means a retirement plan or account created by an employer, by me, or by another person to provide retirement benefits or deferred compensation for me as a participant, beneficiary, or owner,-including a plan or account under the,following sections of the Internal Revenue Code (as amended from time to time): an individual retirement account under §§408, 408A, or 408(q); an annuity or mutual fund custodial account under §403(b); a pension, profit-sharing, stock bonus, or other retirement plan qualified under §401(a); a plan under §457(b), and a nonqualified deferred compensation plan under §409A. To the extent not limited in the Special Transactions section, I give p my Agent the following powers: a. To continue, pay the premium or make a contribution on, modify, exchange, rescind, release, or terminate a Contract, whether or not I am a beneficiary under the contract,and whether owned by me or obtained by my Agent; b. To procure new Contracts for me and any member of my family; .c. To exercise the following rights for Contracts: to obtain a loan secured by a Contract or to borrow against its value; to surrender a Contract and receive its cash surrender value; to exercise any election available under that Contract; to exercise investment powers, if applicable; to change the manner of paying premiums and to select the form and timing of the payment of proceeds; to change or convert the Contract to another type;to sell,assign, or otherwise transfer the Contract. d. To obtain property, casualty, liability or any other insurance for me°and my property. e. With respect to a Plan, I give my Agent the following powers: to select the form and timing of payments and withdraw benefits from the Plan; to make rollovers, including a direct trustee-to-trustee rollover, of benefits from one Plan to another; to establish a Plan in my name; to make contributions to a Plan; to exercise investment powers, if applicable;to borrow from, sell assets to', or purchase assets from a Plan. 5 r ADDITIONAL PROVISIONS Protection for Agent. I understand,acknowledge and anticipate that many of my Agent's actions taken pursuant to specific grants of authority in this instrument could involve her in conflicts of interest (created either by me or by my Agent), or call into question'my'Agent's apparent loyalty to me, or both. This might result from the totality of the circumstances facing the Agent at that time, or by virtue of the Agent's specific actions that might create the conflict of interest. I want my Agent to be free to act in my interest without concern over questionable lawsuits. Therefore, so long as my Agent acts in good faith, she will be protected as follows: a. My Agent does not have an affirmative duty to act under this power of attorney and will not be liable for any claim or demand arising out of her good faith acts or omissions, except for actions or omissions resulting from my Agent's dishonesty, improper motive, or reckless indifference to the purposes of this power of attorney or my best interests. b. My Agent may have competing interests for herself or her affiliates, and I waive any express duty of loyalty imposed under Fla. Stat. §709.2114(2). c. My Agent may have a conflict of interest as provided in Fla. Stat. §709.2116. Despite that section, my Agent may undertake a transaction on my behalf even if another party•to that transaction is:(i)a business or trust controlled by my Agent,or of which my Agent;or any director, officer, or employee of a Corporate Agent, is also a director,officer,or employee; (ii) an affiliate or business associate of my Agent; or (iii) my Agent acting individually. This exception also extends to any relative of such a party. d. I fully indemnify my Agent out of my assets and my estate for any actions,brought against her, and damages she sustains, including attorneys'fees and costs, that have as a basis my Agent's actions or inactions resulting in both a claim for breach of fiduciary duty and actual damages to me or my estate, but this protection does not extend to actions or omissions resulting from my Agent's dishonesty, improper motive, or reckless indifference to the purposes of this power of attorney or my best interests. If my Agent ceases to serve, these provisions for indemnification may be enforced against me or a successor Agent. This right of indemnification extends to the estate,personal representatives,legal successors and assigns of my Agent. r . e. My Agent will not be liable for any actions or omissions by a predecessor agent if the Agent does not participate in or conceal the action or omission. My Agent is not required to review the actions of a predecessor agent, absent actual knowledge by the Agent of wrongdoing. If, however, my Agent has actual knowledge of a breach or imminent breach of fiduciary duty by another agent, including a predecessor agent, my Agent must take action reasonably appropriate in the circumstances to safeguard my best interests. If my Agent in good faith believes that I am not incapacitated;giving notice to me is a sufficient action. Compensation and Expenses. My Agent will be entitled to reasonable compensation and reimbursement for all expenses reasonably incurred by her on my behalf. Foreign Accounts. Despite any power granted to my Agent in this instrument or under r 6 . - 1 law, my Agent may not exercise any power over, or transact any business with respect to, an account in a foreign country,as defined in 31 CFR 1010.350(6)and 1010.350(d),unless my Agent expressly and specifically accepts such authority in writing. Delegation of Powers. My Agent may not delegate the powers given under this Durable Power of Attorney except as follows: to grant a transfer agent or similar person the authority to register securities in my name or the name of a nominee; for investment management purposes as provided in Fla. Stat. §518.112; or to any other person, as may be permitted under the law of another jurisdiction in which this instrument is presented. Suspension of Rights and Duties. All powers granted to my Agent will be suspended immediately if my Agent is determined to be incapacitated by a court having jurisdiction. Use of Copies. As provided in Fla. Stat. §709.2106, a photocopy or electronic copy of this power is sufficient for its exercise,except as may be required for transactions in real estate. Partial Invalidity. If any part of this power of attorney is declared invalid or unenforceable,that decision will not affect the validity of the remaining parts. Limitation on actions of Agent. My Agent may not participate in an action to the extent that a payment or distribution pursuant to that action would discharge a legal support obligation of my Agent. If my Agent is the insured of any insurance policy that I own, my Agent may not exercise any rights or have any incidents of ownership with respect to the policy, including the power to change the beneficiary,to surrender or cancel the policy, to assign the policy, to revoke any assignment, to pledge the policy for a loan, or to obtain from the insurer,a loan against the surrender value of the policy. I hereby revoke all prior general Powers of Attorney that I may have executed(excluding any Power of Attorney With Respect to Health Care of the Person). I retain the right to revoke or amend this general Durable Power of Attorney. Amendments to this Power shall be made in writing by me personally (not by my Attorney-in-Fact) and they shall be attached to the original of this Power. Any grant of a general Durable Power of Attorney made by me subsequent to the date of execution of this Durable Power of Attorney shall revoke this Power unless the subsequent Power contains a statement to the contrary and specifically refers to this Power by its date; provided, however, no subsequent grant of a Durable Power of Attorney With Respect to Health Care of the Person shall be deemed to revoke this Power unless such subsequent Power contains a statement to the contrary and specifically refers to this Power by its date. 7 L In witness whereof, I have executed this Durable Power of Attorney as of the date first written above. Signed in the presence of: Print`Name.. s�n�,�o-•-ra i--s f c i��n Lynn A. Sammuli rint Name: LQ&&a C. ggC a to , Two witnesses as to Lynn-A.-Sammuli7 , STATE OF FLORIDA COUNTY OF MARTIN The foregoing instrument was acknowledged before me on November 13, 2017, by Lynn A. Sammuli. KIM M.BOYLE i.• �• ;c MY COMMISSION 9 GG 023861 o EXPIRES:September 16,2020 C' ''•?,;,t. �edad ThN Ndary Public Undervrtltero otaryublic--State of o ' Personally Known Print Notary Name: Produced Identification My Commission Number is: Type of Identification 0"� My Commission Expires: a i E r ' z Miami shores Village Building Department " 11611 10050 N.E.2nd Avenue r Miami Shores, Florida 33138 Tel: (305) 795.2204 . Fax: (305) 756.8972 Permit No : EL-6-18-1505 ELECTRICAL REVIEWER COMMENTS Need riser diagram, panel schedule and load calculation. Devaney Michael Electrical Inspector and Plan Reviewer AIR Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re-submittal drawings. , RECEIVED JUN 112018 Load Calculation 725 sq ft x3 = 2175 small app x2 = 3000 5175 watts Total load 27,275W 1st 10k @ 100% 10,000W Remainder @40% 7,696W A/C @ 1200 A/C @100% 8,000W Range @ 12,000 251696W Washer @1,500 - Dryer @51000 0000 Ref @1,200 ' . . 0000 0000.. ••.• . Micro @1,200 25,696 W • 71.38�A�1� .• ••.••. 5175 360 V • 0000 0000.. 0000.. 27,275 ••" ""' 0000.. 0000 . 0000.. 0000.. . . • . . . . . 0000.. 0000.. # . . .0609. 00 0 �ERAAiT Miami Shires Village CTY APPROVED BY DATE ZONINGccDEP7 - - DG DEPT C 0 Y SUBJECT ,'O CCNIP[JANCE WI rH ALL FEDERAL STATE ANLj(; ON AND REGULATIONS Electrical Diagram FPL POLE 3 # 2/0 3#1 THWN PNLA PNL.B 1#6 THWN M amp M amp DISC in 11/2 125 Amp DISC M .... ...... 125 Am • ...... .. . ...... 3#1 THWN .•..•• .... . ..... 1#6THWM ...... .,... �Grounding TV Phone in 11/2 .••••. . . . . ...... CWP • Ground(2) 5/8 X 10`Rods 6`Apart ELECTRICAL PAR ,SSM EDULE WIRE . . . . . . WIRE 4D BRKR SIZE CON FUNCTION #. # FUNCTION CON SIZE BRKR LOA 20 A/C 1 WALL M 2• 190 WATER 4EATER 30 . ... ... ... . 30 20 A/C 2 WALL 3 4 WATER HEATER 15 LIGHTS 9" :6: .�. §ATHOL Fle 15 50 RANGE i7,• :$: •• :At i ALL,3; � 50 RANGE 9 10 PUMP 20 Space 11 12 PUMP 20 13 14 15 16 17 18 19 20 21122 23124 a 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 141142 CADS fAC LOADS @100% ;IAL PURPOSE 240 V 1 ST 1'OKW @ 100% :IAL PURPOSE 120V ! REMAINING,LOAD @40% tL APPLIANCE SUBTOTAL 0 ]ROOM GFCI LOAD @125% 1 0 1 RAL LIGHTING AND I PTACLES @ 3W/ SF IDESIGN LOAD IN AMPS € 0 AM F ISF X 3W [SERVICE SICE AMF ! t ELECTRICAL PARE. L SCHEDULE III WIRE •• ••• WIRE 4D 13116SIZECON FUNCTION # # FUNCTION CON SIZE BRKR L'OA 50 RANGE • ' " " ' 50 RANGE 3 4 ••• ••• ••• • 20 ROOM 1 OUTLETS •Q' '(�; ' " "' 20 KITCHEN LAPP -7•• ,8; ••• ' one ••• 20 OUTLETS LIVING 1 9 10 '20 ROOM 2 OUTLETS 11 12 20 REF 1 13 14 20 KITCHEN 2 APP 15 16 20 ROOM 3 OUTLETS 17 18 20 LIGHTS 19 20 15 LIGHTS 21 22 15 LIGHTS 231 24 15 FRONT LIGHTS 25 26 15 BACKYARD LIGHTS 27 28 29 30 31 32 33 34 35136 37138 39 40 41 42 DADS YAC LOADS @ 100% :IAL PURPOSE 240 V 0 ST 10KW @ 100% ;IAL PURPOSE 120V #REMAINING LOAD @ 40% { tL APPLIANCE �: SUBTOTAL 0 ROOM GFCI LOAD @125% I 0 =RAL LIGHTING AND L. =PTACLES @ 3W/ SF DESIGN LOAD IN AMPS 0 AMF ISF X3 SERVICE SICE AMF a