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MC-18-1154�` yKORES G�! Fio'ii"vA Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit NO. MC-5-18-1154 Permit Type: Mechanical - Residential erillitWork Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 5/1012018 1 Expiration: 11/06/2018 Project Address Parcel Number Applicant 54 NE 95 Street 1132060130470 Miami Shores, FL 33138- Block: Lot: JUDITH WILLIAMS Owner Information Address Phone Cell JUDITH WILLIAMS 54 NE 95 Street (305)756-1312 MIAMI SHORES FL 33138-2707 Contractor(s) Phone Cell Phone HAVANA AIR CONDITIONING, INC (305)558-9136 s: Info: REPLACE AT EXISTING LOCATION HVAC U ion: Residential In Review ments: Denied ning: 3 Fees Due Amount CCF $3.60 DBPR Fee $3.15 DCA Fee $2.10 Education Surcharge $1.20 Permit Fee $210.00 Scanning Fee $9.00 Technology Fee $4.80 Total: $233.85 Valuation: $ 6,000.00 Total Scl Feet: p Date Approved:: In Review Type of Work: REPLACE AT EXISTING LOCATION I - Pay Date Pay Type Amt Paid Amt Due Invoice # MC-5-18-67368 05/01/2018 Check #: 1013 $ 50.00 $ 183.85 05/10/2018 Check* 1014 $ 183.85 $ 0.00 Available Inspections: Inspection Type: Final Rough Duct Review Mechanical Underground 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 p1l the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zon' Futher o ; I authorize the abo a named contractor to do the work stated. % V1r, Q, I G [ 0 May 10, 2018 Authori d Signature. wner / Applicant / Contractor / Agent Date Buildin Department Copy May 10, 2018 1 Miami Shores Village 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 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING FBC2Q0 Master Permit No. �C�O97 Sub Permit No._�\ C la 1�54 ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: FolioJParcel#: V {// �l.J ` O 7 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: �OWNEl2: N� (Addires`s1 cify:`_A ,(Fee Simple Titleholder): ZvArw-•A1 i Tenant%Lessee Name: �imail` h/LKJAa CONTRACTOR:CompanyName: �149� Address: O pO / ule r r a0— City: �. Qualifier Name: (0.$ f✓ ,P/r -oyr 4 oRe4-7 'fib' i a-b I-'Zipi 2; l 3 g �J J;-Ie-- Phone#: r_State: rL Zip:�— State Certification or Registration #: C,� �O li �� Certificate of Competency #: _ DESIGNER: Architect/Engineer: I Phone#: Address: ILo City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: _a�.. Type of Work: ❑ Addition ❑a'Alteration ❑ New © Repair/Replace ❑ Demolition Description of,W/ork: Specify color of color thru tile: Submittal fee $ 156 L7 Permit�Fee $ Scanning Fee $ Radon Fee $ �` O Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) CCF $ CO/CC $ DBPR $ 3 • Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ ( 3 • GS Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address city State Zip 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. Signature v� ��� �OINNER. or AGENT� The foregoing instrument was acknowledged before me this _ day of'�5-�� 20 i' `( — -by is personally known to me or who has producedr-�,—Q,L as identification and who did take an oath. CHOTARYAURBLICa ePrint _ Cak-"� P F— - e: � r t, Seal: ############### APPROVED BY (Revised02/24/2014) ANA I FERREIRA Notary Public State of New Jersey / CONTRACTOR The foregoing instrument was acknowledged before fme this day of ,, 20 �c'J by �% e/�1�4e who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: ISABELVALDES _ . •�i3iV Pu ". C &i•t Notary Public — State of Florida • Commission # GG 161156 My Comm. Expires Mar 13.2022 Sign: '.'FOFc Bonded:hro4hNoon! Notary Assn. Print' Seal: i '1, 1�Notary Pubrrc — SIA!e c= Fl, -ca kr4ed Vrojo Na: Examiner Zoning Structural Review Clerk i a►�r.6 f OILiriff NUN � � �ow,o Summary Report Property Information Folio: 11-3206-013-0470 Property Address: 54 NE 95 ST Miami Shores, FL 33138-2707 Owner JUDITH B WILLIAMS TRS JUDITH B WILLIAMS REV TR Mailing Address 54 NE 95 ST MIAMI SHORES, FL 33138 USA PA Primary Zone 1100 SGL FAMILY - 2301-2500 SQ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds / Baths / Half 3/2/1 Floors 1 Living Units 1 Actual Area 1,904 Sq.Ft Living Area 1,605 Sq.Ft Adjusted Area 1,755 Sq.Ft Lot Size 9,675 Sq.Ft Year Built 1941 Assessment Information Year 2017 2016 2015 Land Value $241,547 $241,547 $184,000 Building Value $122,148 $122,148 $122,148 XF Value $26,571 $26,580 $16,027 Market Value 1 $390,2661 $390,2751 $322,175 Assessed Value 1 $390,2661 $126,5011 $125,622 Benefits Information Benefit Type 2017 2016 2015 Save Our Homes Cap Assessment Reduction $263,774 $196,553 Homestead Exemption $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 Senior Homestead Exemption $50,000 $50,000 Widow Exemption $500 $500 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). (Short Legal Description I 1 5341 6 53 42 MIAMI SHORES SEC 1 AMD PB 10-70 W1/2 LOT 5 & LOT 6 BLK 4 LOT SIZE 75.000 X 129 OR 12618-1397 0885 5 Generated On: 3/7/2018 2017 Aerial Photography Taxable Value Information 20171 2016 2015 County Exemption Value $0 $100,500 $100,500 Taxable Value 1 $390,2661 $26,0011 $25,122 School Board Exemption Value 1$0 $25,5001 $25,500 Taxable Value 1 $390,2661 $101,0011 $100,122 City Exemption Value 1 $0 $50,5001 $50,500 Taxable Value 1 $390,266 $76,001 $75,122 Regional Exemption Value $0 $50,500 $50,500 Taxable Value 1 $390,2661 $76,0011 $75,122 Sales Information Previous Price OR Book- Qualification Description Sale Page 04/07/2016 $100 30D41-1482 Corrective, tax or QCD; min consideration 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.govriinfo/disclaimer.asp Version SUCCESSOR TRUSTEE'S CERTIFICATION BEFORE ME personally appeared MICHAEL P. WILLIAMS, as Successor Trustee of the Judith B. Williams Revocable Trust Agreement dated the 7" day of April, 2016: 1. On April 7, 2016, JUDITH B. WILLIAMS a/k/a JUDITH B. BROOKS established a Revocable Trust by written instrument of that date and such Trust named JUDITH B. WILLIAMS a/k/a JUDITH B. BROOKS as the initial Trustee to act thereunder. As to said Trust, the undersigned is the Successor Trustee currently holding office. 2. The provisions of said Trust provide in ARTICLE V thereof for distributions of income and principal to JUDITH B. WILLIAMS during her lifetime and for her benefit during any period of her incapacity and in ARTICLE VII thereof upon her death, terminates by distribution to certain beneficiaries. 3. ARTICLE X names son, MICHAEL P. WILLIAMS, as Successor Trustee and if he is unwilling or otherwise unable to act, appoints attorney, ANDRE' R. FOURNIER, as alternate. 4. ARTICLE XI of such Trust specifically grants the Trustee the power to invest and reinvest the Trust's assets and to convey any and all real and personal property held by the Trustee at any time, including Settlor's homestead residence. No contrary power or restrictions appear in the Trust documents. 5. The foregoing provisions of the Trust have been in full force and effect from April 7, 2016, through the date hereof. Attached hereto are pertinent portions of the Trust consisting of Page 1, Pages 11 through 18 and either a copy of Settlor's death certificate or obituary. 6. The purpose of these provisions is to show that this Trust is an active Trust rather than a passive Trust. Dated at Miami -Dade County, Florida; this —� day of , 2016. MICHAEL . WILLIAMS, Successor Trustee STATE OF FLORIDA ) COUNTY OF MIAMI-DADE) I HEREBY CERTIFY that on this day, before me, an officer duly authorized in the State aforesaid and in the County aforesaid to take acknowledgments, personally appeared MICHAEL P. WILLUMS, as Successor Trustee, who is personally known to me or who has produced !.— as identification, and who executed the foregoing instrument and he acknowledged efb ore me that he executed the same. WITNESS my hand and official seal in the County d Stat as said this (S day o2016. r Notary Public, tate of Florida taY'° ANDRE' R. FOURNIER MY coMISSION # FF 12M * EXPIRES: August19,2018 'ikoW 8oa*ThMBQWN0WYSWi= THE JUDITH B. WILLIAMS REVOCABLE TRUST AGREEMENT TRUST AGREEMENT made this. day of , (, 2016, between JUDITH B. WILLIAMS a/k/a JUDITH B. BROOKS, (hereinafter called the "Settlor"), and JUDITH B. WILLIAMS a/k/a JUDITH B. BROOKS, (hereinafter called the "Trustee"). ARTICLE I - NAME OF TRUST This Trust shall, for convenience, be known as the JUDITH B. WILLIAMS REVOCABLE TRUST AGREEMENT dated the -�— day of AItie, 2016, and it shall be sufficient that it be referred to as such in any instrument of transfer, deed, assignment, bequest, or devise. ARTICLE H - TRUST PROPERTY The Settlor hereby transfers and delivers to the Trustee the property listed on Schedule A annexed hereto, to have and to hold the same and any cash, securities, or other real and personal property which the Trustee may, pursuant to any of the provisions hereof, at any time hereafter hold or acquire, all of such property being hereinafter referred to as the Trust Estate, for the uses and purposes and upon the terms and conditions herein set forth. The Settlor reserves the right to reside upon any real estate placed in the Trust as her . permanent residence during her life, it being the intent of this provision to retain for the Settlor the requisite beneficial interest and possessory right in and to such real property to comply with j�" H. The singular includes the plural and the plural includes the singular. ARTICLE M - TRUSTEE A. Appointment of Trustee: The Settlor appoints herself, JUDITH B. WILLIAMS a/k/a JUDITH B. BROOKS, to serve as Trustee of the JUDITH B. WILLIAMS REVOCABLE TRUST AGREEMENT dated the —!:�- day of Z6 2016, created hereunder. 2. Upon the death, or mental or physical incapacity of JUDITH B. WILLLA MS a/k/a JUDITH B. BROOKS, the individual Trustee, as so certified by Marc Saltzman, M.D. as provided for in Article V, second paragraph on Page 4 above in writing, Settlor appoints MICHAEL PETE WILLIAMS to serve as Successor Co -Trustee. In the event MICHAEL PETE WILLIAMS is unable or unwilling to serve, then in that event, Settlor appoints ANDREI R. FOURNIER to serve as Successor Trustee. My Successor Trustee shall serve without responsibility for any acts of the original Trustee. Upon receipt of written notice of the incapac- ity of JUDITH B. WILLIAMS a/k/a JUDITH B. BROOKS, the individual Trustee, the Successor Co -Trustee is authorized and directed to transfer all assets to the name of Successor Trustee and in so doing is authorized to execute in their capacity as Successor Trustee, any stock powers or other instruments necessary to effect such a transfer of ownership. 3. Any successor to JUDITH B. WILLIAMS a/k/a JUDITH B. BROOKS, whether by transfer of situs of any Trust hereunder, consolidation, merger, or by resignation or otherwise, shall succeed as Trustee with like powers and effect as though originally named as such. In the event that one or both of the named Successor Trustees are unable or unwilling to act, then the surviving or remaining named alternate Trustee shall either elect to act or appoint a Successor Trustee to act in his or her capacity. 4. The title to the Trust Estate shall vest forthwith in any Successor Trustee acting pursuant to the foregoing provisions hereof, but any resigning or removed Trustee shall execute all instruments and do all acts necessary to vest such title in any Successor Trustee without court accounting. A Successor Trustee shall have no duty to examine the accounts, records, and acts of the previous Trustee or Trustees and shall in no way or manner be responsible for any act or omission to act on the part of the previous Trustee. Any claim or action against any previous Trustee must, in any event, be asserted or filed by any beneficiary within one year after such Trustee ceases to serve. . 6. Settlor's Trustees shall be entitled to be reimbursed all expenses advanced and to a fee consistent with what is normal and customary in the community and any benefit otherwise given any of my trustees shall NOT be taken into consideration with respect to fees. ARTICLE XII - POWERS OF TRUSTEE In administering the Trust established hereunder, the Trustee shall have the express powers enumerated herein, together with all other powers conferred by law upon Trustees generally, and may exercise them at any time and from time to time in any valid manner with or without court order, as follows: A. Retain Trust Estate: To retain, without liability for loss or depreciation Ik )_';J� 12 resulting from such retention, the original assets and all other property hereafter transferred, devised, or bequeathed to the Trustee for such time as the Trustee shall deem advisable although such property may not be of the character prescribed by law or by the terms of this instrument for the investment of trust assets and although it represents a large percentage of all of the Trust Estate; said original property may accordingly be held as a permanent investment. B. Hold Uninvested Cash and Unproductive Property: For any periods deemed advisable, to hold cash, uninvested, even though the total amount so held is disproportionate under trust investment law or would not be permitted without this provision and to retain or acquire and hold unproductive realty or personalty. C. Invest and Acquire: To invest and reinvest trust assets in any type of property or security without regard to the proportion that investment of the type selected may bear to the entire Trust Estate, without limitation to the classes of trust investment authorized by law, and without regard to the possibility that the investments may be in new issues or in new or foreign enterprises. The property acquired may be realty or personalty, and may include life insurance, bonds, debentures, leaseholds, options, easements, mortgages, notes, mutual funds, investment trusts, common trust funds, voting trust certificates, and any class of stock or rights to subscribe for stock, regardless of whether the yield rate is high or low or whether or not the new asset produces any income at all. It is intended that the Trustee shall have the authority to act in any manner deemed in the best interest of the Trust involved, regarding it as a whole, even though certain investments considered alone might not otherwise be proper. D. Exercise Options and Conversion Privileges: To exercise any options, rights, and conversion privileges pertaining to any securities held by the Trustee as trust assets. E. Receive Additional Property: To receive additional property from any source, including the Personal Representative of Settlor's estate and the Trustee or beneficiary of any other trust, by whom created, and to hold and administer this Trust, by whomever created, and to hold and administer this property as part of the Trust Estate. F. Sell and Lease: To sell, convey, grant options to purchase, lease, transfer, exchange, or otherwise dispose of any trust asset on any terms deemed advisable, to execute and deliver deeds, lease, bills of sale, and other instruments of whatever character, and to take or cause to be taken all action deemed necessary or proper in connection therewith. G. Insure: To carry any insurance deemed advisable with any insurer against any hazards, including public liability, and to use insurance proceeds to repair or replace the asset insured. `, 13 H. Lend: On any terms deemed advisable, to lend trust funds to any borrower, including the Personal Representative of Settlor's estate and the trustee or beneficiary of any trust, by whomsoever created, and to change the terms of these loans. This authorization includes the power to extend them beyond maturity with or without renewal and without regard to the existence or value of any security therefor, to facilitate payment thereof, to change the interest rate thereof, and to consent to the modification of any guarantee relating thereto. I. Borrow: To borrow whatever money the Trustee deems desirable for any trust on any terms from any lender including the Trustee and the personal representative of the Settlor's estate, and the Trustee or beneficiary of any other trust, by whomsoever created, and to mortgage, pledge, or otherwise encumber as security any assets of the borrowing Trust. J. Term or Duration of Obligation: Incident to the exercise of any power, to initiate or change the terms of collection or of payment of any debt, security, or other obligation of or due to the Trust Estate, upon any terms and for any period, including a period beyond the duration or the termination of any or all trusts. K. ComRromise or Abandonment of Claims: Upon whatever terms the Trustee deems advisable, to compromise, adjust, arbitrate, sue on, defend in favor of any trust; to abandon any asset the Trustee deems of no value or of insufficient value to warrant keeping or protecting; to refrain from paying taxes, assessments, or rents, and from repairing or maintaining any asset; and to permit any asset to be lost by tax sale or other proceeding. L. Distribution in Cash or in Kind: To distribute any shares in cash or in kind, or partly in each, and the Trustee's valuation of assets upon making distribution shall, if made in good faith, be final and binding on all beneficiaries. A Use of a Nominee: To hold any or all of the trust assets, real and personal, in the Trustee's own name, or in the name of any corporation, partnership, or other person as the Trustee's nominee for holding the assets, with or without disclosing the fiduciary relationship. N. Bid in or Take Over Without Foreclosure: To foreclose any mortgage, to bid in the mortgaged property at the foreclosure, and to retain it or dispose of it upon any terms deemed advisable. O. Pay Off Encumbrances: To pay off any encumbrance on any trust asset and to invest additional amounts to preserve it or to increase its productivity. P. Vote Stock: To vote stock for any purpose in person or by proxy, to enter into 14 a voting trust, and to participate in corporate activities related to any trust hereunder in any capacity permitted by law, including service as officer or director. Q. Participate in Reorganizations: To unite with other owners of property similar to any held in trust in carrying out any plan for the consolidation, merger, dissolution, liquida- tion, foreclosure, lease, sale, incorporation, reincorporation, reorganization, or readjustment of the capital or financial structure of any association or corporation in which any trust has a financial interest; to serve as a member of any protective committee; to deposit trust securities in accordance with any plan agreed upon; to pay any assessments, expenses, or other sums deemed expedient for the protection or furtherance of the interests of the beneficiaries hereunder; and to receive and retain as trust investments any new securities issued pursuant to the plan, even though these securities would not constitute authorized trust investments without this provision. R. Employment of Assistants and Agents: To any extent reasonably necessary, to employ attorneys, accountants, tax specialists, brokers, investment counselors, realtors, managers for businesses, farms, ranches, groves and forests, technical consultants, attorneys -in -fact, agents, and any other consultants and assistants the Trustee deems advisable for the proper administration of the Trust Estate. S. Establishment and Maintenance of Reserves: Out of the rents, profits, or other gross income received, to set aside and maintain reserves to the extent deemed advisable to meet present or future expenses, including taxes, assessments, insurance premiums, debt amortization, repairs, improvements, depreciation, obsolescence, general maintenance, and reasonable compensation for services, including services of professional and other employees authorized hereby, as well as to provide for the effects of fluctuations in gross income and to equal or apportion payments for the benefit of beneficiaries entitled to receive income. T. Manage Realtv: To deal with realty in any manner lawful to an owner thereof. This authority includes the right to manage, protect, and improve it, to raze, alter and repair improvements, to sell or contract to sell it in -whole or in part, to partition it, to grant options to purchase it, to donate it, to convey to, to acquire it, release, or grant easements or other rights relating to it, to dedicate parks and thoroughfares, to subdivide it from time to time, to lease it in whole or in part, and to renew, extend, contract for, and grant options in connection with leases. Leases, contracts to sell, mortgages, and any contract entered into by the Trustee can be made on any terms and for any period, including a period beyond the duration or termination of any or all trusts. U. Carry on Business: With reference to any business that may be or become a part of the Trust Estate whether organized as a sole proprietorship, partnership, or corporation, upon such terms, for such time, and in such manner as the Trustee deems advisable: 1?1"r, 15 1. To hold, retain, and continue to operate such business solely at the risk of the Trust Estate and without liability on the Trustee's part for any losses resulting therefrom. 2. To incorporate, dissolve, liquidate, or sell such business at such time and upon such terms as the Trustee deems advisable. 3. To borrow money for business purposes and to mortgage, pledge, or otherwise encumber the assets of the Trust Estate to secure the loan. 4. To exercise with respect to the retention, continuation, and disposition of such business all the rights and powers for which the Settlor would have been capable, including all powers as may now or hereafter be conferred upon the Trustee by law or as may be necessary to. enable the Trustee to administer the Trust Estate in accordance with the provisions of this Agreement, subject to any limitations thereof that may be provided for herein. V. Allocation to Principal and Income: All receipts of money or property paid or delivered to the Trustee and all expenses shall be allocated to principal or income in accordance with the laws of the State of Florida. ARTICLE XIII - CONSTRUCTION OF AGREEMENT The headings and subheadings used throughout this Agreement are for convenience only and have no significance in the interpretation of the body of this Agreement, and Settlor directs that they be disregarded in construing the provisions of this Agreement. IN WITNESS WHEREOF, I, JUDITH B. WILLIAMS a/k/a JUDITH B. BROOKS, as Settlor of the foregoing Trust Agreement, have hereunto set my hand and seal this day of 1, 2016. h a U Ak A h � JUDI B. WI LLIAMS a.Wa JUDITH B. BROO , Settlor This instrument was signed, sealed, published and declared by the Settlor, JUDITH B. WILLL ,MS a/k/a JUDITH B. BROOKS, as her Revocable Trust Agreement in our joint 16 r, ti presence, and at her request we have signed our names as attesting witnesses in her presence and in the presence of each oth on the date first above written. r Residing at �d%syrr Residing at .2 a -05. STATE OF FLORIDA ) ) ss COUNTY OF MIAMI-DADE) I, JUDITH B. WILLIAMS a/k/a JUDITH B. BROOKS, declare to the officer taking my acknowledgment of this instrument, and to the subscribing witnesses, that I signed this instrument as my Revocable Trust Agreement. JUD B. WILLIAMS a/k/a JUDITH B. BRO , Settlor We, BEVERLY ANN SIMPSON and WTL.L.TAM n. STMPg0N, Mhavebeen sworn by the officer signing below, and declare to that officer on our oaths that the Settlor declared the instrument to be the Settlor's Revocable Trust Agreement and signed it in our presence and that we each signed the instrument as a witness in the presence of the Settlor and of each other. - r� `�"I Witness Witness Acknowledged and subscribed before me by the Settlor, JUDITH B. WILLIAMS aWa JUDITH B. BROOKS, who is personally known to me or who has produced N . A. as identification, and sworn to and subscribed before me by the witnesses, B E V ER LY ANN S I MP S 0 N who is personally known to me or who has produced N.A. as identification, and TIILLIAM L. SIMPSON. JR. ,who is personally known to me or who has produced N.A. as identification, and (i1 n 17 subscrib d by me in the presence of the Settlor and the day of t C , 2016. on the V. Public, State of Florida ��`; :"he, ANDRE� a FOUHtdiSR * MY COMMISSION ! FF.1�B88 * EXPIRES; Aug�t 19, 2018 �44OF 60edEdhWAt a Y " ACCEPTANCE BY TRUSTEE The undersigned hereby accepts the trust imposed by the foregoing Trust Agreement and agrees to serve as Trustee upon th .terms and conditions therein set forth. Dated this 1-� day of eel, 2016: Signed, sealed and delivered in the presence of rk . We, C ` I mrx.ROOKS, Trustee STATE OF FLORIDA ) ) ss COUNTY OF MIANII-DADE) The foregoing instrument was acknowledged before me' this _ day of t..� 2016, by JUDITH B. WILLIAMS a/k/a JUDITH B. BROOKS, Trustee, who is personally k_nnown o me or who has produced p/°�- as ident capon; and wgo did take an oath. of Public, State of Florida � r ►u AWRE' R. FOUNIR `� °. • ' * MY COMMISSION II FF 1280 * EXPIRES; Au0U119, 2018 �,�� �gyl�y8wrtoes 18 SCHEDULE "A" (Description of all stocks, bonds, life insurance policies and other assets which are to be delivered to the Trustee at time of execution of the Agreement)., Real Estate: Lot 4 and East %2 of Lot 5, in Block 4, of MIANII SHORES SECTION 1, according to the Plat thereof, as recorded in Plat Book 10, at Page 70, of the Public Records of Miami -Dade County, Florida, a/k/a 86 N. E. 95' Street, Miami Shores, FL 33138 West %2 of Lot 5 and Lot 6, in Block 4, of NHAMI SHORES SECTION 1, according to the Plat thereof, as recorded in Plat Book 10, at Page 70, of the Public Records of Miami -Dade County, Florida, a/k/a 54 N. E. 95" Street, Miami Shores, FL 33138 Tract 39, of BISCAYNE GARDENS, SECTION A, according to the Plat thereof, as recorded in Plat Book 40, at Page 41, of the Public Records of Miami -Dade County, Florida, a/k/a 325 N. E. 152nd Street, North Miami, FL 33162 Lot 18, in Block 238, of INDIAN LAKE ESTATES, UNIT 6, according to the Plat thereof, as recorded in Plat Book 40, at Page 41, of the Public Records of Polk County, Florida Lot 19, in Block 238, of INDIAN LAKE ESTATES, UNIT 6, according to the Plat thereof, as recorded in Plat Book 40, at Page 41, of the Public Records of Polk County, Florida + Lot 1, in Block 2, of SUNSHINE ESTATES SECTION 1 PLANTATION KEY, according to the Plat thereof, as recorded in Plat Book 4, at Page 63, of the Public Records of Monroe County, Florida Lot 28, in Block 78, of INDIAN ,RIVER ESTATES UNIT NO.9, a subdivision, according to the Plat thereof, as recorded in Plat Book 10, at Page 74, of the Public Records of St. Lucie County, Florida 7/18/2017 t MiamRMde Official Records - Print Document Iftlll iflil Illlf illll tllli IIII! IIIII 1111 illl CFN 2016RO226O93 OR SK 30041 Pss 1482-1485 Wss) RECORDED 04/18/2016 13zO5:05 DEED DOC TAX $0.60 SURTAX $0.45 HARVEY RUUIN+ CLERK OF COURT f1IAf1I-DADS COUNTY► FLORIDA MIENTURE Folio Nos.:11-3206-013-046& 11-3206-013,0470 and 30-2218-002-0450 N THIS INDENTURE made this day of lu 2016, by and between JUDITH B. WILLIAMS &Wa JUDITH B. BROOKS, an utinremwTied widow, hereinafter referred to as the Grantor, and JUDITH B. WILLIAMS a/k1a JUDITH B. BROOKS, as Trustee of the JUDITH B.JVULIAMS REVOCABLE TRUST AGREEMENT DATED THE {% DAY OF 181,G— 2016, hereinafter refused to as Trustee, whose post office address is 54 N. E. 956 Street, Miami Shores, FL 33138-2707. Grantor, in consideration of the sum of Ten ($10.00) Dollars and other good and valuable considerations, receipt of which is hereby acknowledged, does hereby grant, bargain, sell and convey to the Trustee, her successors and assigns, all Grantor's interest in the following described property, situate in Miami -Dade County, Florida, to -wit: Lot 4 and East %a of Lot 5, in Block 4, of MIAMI SHORES SECTION 1, according to the Plat thereof, as recorded in Plat Book 10, at Page 70, of the Public Records of Miami -Dade County, Florida, a/k/a 86 N. E. 95* Street, Miami Shores, FL 33138; West'/ of Lot 5 and Lot 6, in Block 4, of MIANII SHORES SECTION 1, according to the Plat thereof, as recorded in Plat Book 10, at Page 70, of the Public Records of Miami -Dade County, Florida, aWa 54 N. E. 95* Street, Miami Shores, FL 33138, this property is the homestead property of the Grantor/Trustee; and Tract 39, of BISCAYNE GARDENS, SECTION A, according to the Plat thereof, as recorded in Plat Book 40, at Page 41, of the Public Records of Miami -Dade County, Florida, aWa 325 N. E. 152'd Street, North Miami, FL 33162. Book30041 /Pagel 482 CFN#20160226093 Page 1 of 4 https://www2-miamWadedork.com/OMdafRemrdsftnd)=menLaspx?QS=YaoUK)muy2CFYMzKfgeRbrhXXpxOAZRR3sgivNaGvBNXJCG%2bS%2... 1/4 7/18/2017 Miami -Dade Official Records - Print Document To have and to boll said real estate with the following powers and for the following uses and purposes, to -wit: l . The Trustee is vested with full rights of ownership over the above-dambed real estate and Trustee is specifically granted and given the power and authority: a. To protect and conserve said real estate and improvements looted thereon and to pay the taxes assessed thereon. b. To sell said real estate, for cash or on credit, at public or private sale, to exchange said veal estate for other property and to grant options to sell said property, and to determine the price and terms of sales, exchanges and options. C. To execute leases and subleases for terms as long as 20 years, to subdivide or improve said real estate and tear down or alter improvements, to grant easements, give consent and make con -tracts relating to said real estate or its use and to release or dedicate any interest in said real estate. d. To borrow money and to mortgage, pledge or encumber any or all of the said real estate to secure payment thereof. e. To mazwiM control and operate said real estate, to collect the rents, issues and profits, to pay all expenses thereby incurred, and in addition, to manage and operate any business that may now or hereafter be operated and maintained on said real estate, and in general, to exercise any powers authorized by the provisions of Chapter 737, Florida Statutes. f. The Trustee's liability hereunder, under the Trust Agreement or by operation of law to any person, firm or corporation is limited to the tonal assets and the Trustee shall not become individually or personally obligated in any manner related thereto. 2. The Trustee shall hold said real estate and make distnbubons of 'd real estate or of the proceeds derived therefrom in accordance with the terms and conditions f that certain Judith B. Williams aWa Judith B. Brooka Revocable Trust Agreement dated 11tL' 2016, and any amendments thereto. Book30041 /Pagel 483 CFN#20160226093 Page 2 of 4 MtpsJ/www2.miami-dadederk.corn/OMciafRecord&q3ldntDocumentaspx7QS=YaoUfOzxy2CFYMzKfgeRbdiXXpxOAZRR3sgivNaGvBNXJCG%2bS%2... 214 7/18/20117 Mlami-Dade Official Records - Pdnt Document 3. No purchaser, grantee, mortgagee, lessee, assignee or any other person dealing with the Trustee need see to the application of any proceeds of any sales, lease, mortgage or pledge, but the receipt of the Trustee shall be a complete discharge and acquittance therefore. Any and all persons, including but not. limited to the grantees, mortgagees, leases, transferees and assigns dealing with said Trustee need not inquire into the identification or status of any beneficiary under this deed or any collateral instrument nor iuquire into or ascertain the authority of such Trustee to act in and exercise the powers granted by this deed or adequacy or disposition of any consideration paid to the Trustee nor inquire into the provisions of said unrecorded Trust Agreement and any amendments thereto. 4. The Grantor recites that this conveyance is made in conformance with the provisions of Section 689.071, Florida Statutes. 5. By her acceptance of this conveyance, the Trustee covenant and agree to do and perform the duties, acts and requiremvirts upon her binding. 6. Each and every power herein above set forth may be exercised by any Trustee. Any instrument executed by any Trustee or any act taken by any Trustee shall be binding upon the trust and all of the Trustees as fully and completely as if all Trustees had executed said instrument or taken said action. 7. The Successor Trustee(s) shall have all of the title, powers and discretion herein given to the Trustee, without any act of conveyance or transfer. A certificate signed by any Trustee or any Successor Trustee under this instrument and acknowledged by himther before a Notary Public shall be conclusive evidence upon all persons and for all purposes of the facts stated in the certificate representing the terms of this instrument and the identity of the Trustees who from time to time are serving under it. NOTE TO PROPERTY APPRAISER: The Grantor conf rras that under the tarns of the Trust referred to above, the Grantor has not less than a beneficial interest for life and is entitled to a homestead tax exemption pursuant to the provisions of Florida Statute 196.041(2). IN WITNESS WHEREOF the Grantor has signed and sealed dus Deed the date above written. Book30041 /Pagel 484 CFN#20160226093 Page 3 of 4 https:l/wwN2.mfamWadecleriLcomlOitidafRecords/PrintDocument.wpx?QS=YaoUK)zxr 2CFYWWgeRbdiXXpxoAZRR3sgjvNaGvBNXJCG%2tS%2... 3/4 7/1812017, Miami -Dade Official Records - Print Document OR SK 30041 PG 1485 LAST PAGE Signed, sealed and delivered in our presence., R rtII , JUD . WILLIAMS awa JUDITH 1 a BR Ks O VVitn 54 N. E. 95d'Street Miami Shores, FL 33139-2707 Signature of Witness Print Name of Witness STATE OF FLORIDA ) COUNTY OF MIAMI-DADS) t( The foregoing Warranty Dad was acknowledged before me this day of '41L.— 201 4, WILLIAMS a/k/a JUDrM B. BROOKS, an anremarried widow, who i(personally kno or has produced Al as o did take an oath. lic, State of Florida Prepared by: ANDRE! R. FOURNIER, ESQ. P.O. Box 610277 North Miami, FL 33261 Book30041 /Pagel 485 CFN#20160226093 ,��, rnraorifi�aeafa�+sl� ra�uel�.aole flalll>lef areyts+tar .. Page 4 of 4 httpsJ/www2.miami-dadederkcom/OMcialRecords/PrintDocumentaspx?QS=YeoUfOncry2CFYMzKfgeRbdiXXpxoAZRR3sgjvNaGvBNXJCG%2bS%2... 4/4 Toll Free I - 8 6 I ) E AT 1 -1 N C"J ..... .... . No Its BUREAU of ,VITAL STATISTICS "Ryl CERTIFICATION OF DEATH STATE FILE NUMBER. 2016058682 DATE ISSUED: April 18,2016 DECEDENT INFORMATION STATE FILE DATE: April 15, 2016 NAME: JUDITH B W1_4*,MS AKA: JUDITH sRoqgS,,.! DATE OF DEATH: Ap I IiF YEARS, 2016 SEX FEMALE AGE: 077 DATE OF BIRTH: a N"mber 22,1938 SSN: 2254"294 BIRTHPLACE: APPALACHIA, VIRGINIA, UNITED STATES PLACE WHERE DEATH OCCURRED: INPATIENT FACILITY NAME OR STREET ADDRESS: CLEVELAND. CLINIC AND HOSPITAL. LOCATION OF DEATH: WES;TOk,:.IjftbWARD 0OU!Wj*Q331 SURVIVING SPOUSE, ONCEDEmrs,"WINCE AND HISTORY INFOW -0 N T MARITAL STATUS: WIDOWED SPOUSE (IF FEMALE, MAIDEN NAME): NONE RESIDENCE: 54 NE 95TH STREET, MIAMI SHORES, FLORIDA 33138,UNITED STATES COUNTY: MLAMI-DADE OCCUPATION, INDUSTRY: REGISTERED NURSSi, fkIVATE DOCTOR RACE: X White _B" or Atican Ameripaq Asian Indian _`Chinese _FIQP!nO Native Hawaiion�; —' American Indian QrAWwn Native —Tribe: —Japanese _j(orean V1 etnamew —Guamian or Chain;,,,at'I:o—Samoan —OtherPsWisl: Other Asian: —Other' —UnIcrum _Other OR HAMAN ORIGIN? NO, NOT OF HISPANICIHAMAN ORIGIN -,: EDUCAI,.I.ON: BACHELORS DEGREE, EVER IN U.$.' -AIRMED FORCES?NO 7 PAR911111""XND INFORMAWV INFORMA11`10N FATH8 ! R CHARLES Bd MOTHER: CHLOE WOMPLER INFORMANT: MICHAEL WILLIAMS RELATIONSHIP TO DECEDENT- SON INFORMANTS ADDRESS: 96 ROXITICUS ROAD.., fAlt HILLS, NEW JERSEY OMI, UNITED STATES PLACE OF DISPOSITION AND FU.. FACILITY INFORMATION PLACE OF DISPOSIT16N, - WOODLAWN, METEIRY NO-M. MIAMI, FLORID METHOD OF DISPOSMOW BURIAL FUNERAL DIRECTOR/LICENSE NUMBER- C1REGQ L MASON, F044537 FUNERAL, FACILITY: GREGG L MAOON FUNERAL HOME F041 706 10936 NE*1W AVENUE, MIW RIDA 33161 CER10"IER INFORMATION' -TYPE OF CERTIFIER: CERTIFYING PHYSICIAN MEDICAL EXAMINER CASE NUMBER: NOT APPLICABLE TIME OF DEATH (24 hr� 1665 CERTIFIER'S NAME* FREDERICK SCOTT ROSS CERTIFIER'S LICENSE NUMBER: ME1116180 NAME OF ATTENDING -PHYSICIAN (if otherthen Qi&W): NOT ENTERED State Registrar REQ: 20169WOO TM Asdw wounm omnm THAT "M .16 A I TRUE AM OMECT OWY I* THE 0MCLAL RECORD ON FU EN TWS 0FRCE. THE oocL"gwV,*N= OR M40TOCOPIED'qk 6Ed$M PAPER MEN WATERMAIlKa OF THE GREAT VASNING: SEAL OF T."E Irr , OF FLORIDA. 00 Nt�� A"!PT WMICIft VERWYNG THE PWOM'OF THE WATEP, E a, 'T MARKEL . M FACE CONTA 4*00LORED RACKGROUND, 00L.0 EMS SEAL. AND E 0 T, LfME8VfflHMT THE DOCUMMFrW[LL Nor PR=JCE 'rFLTE,,,.= llwr Al COLOR GO". 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