PL-18-1503gNOREy
0
hF`'�dV
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit NO. PL-6-18-1503
Permit Type: Plumbing - Residential
Per m it Work Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 6/6/2018 1 Expiration: 12/03/2018
r-rotect r+aaress Parcel Number Applicant
1130 NE 91 Terrace 1132050010410
Miami Shores, FL Block: Lot: GABRIELA MEKLER
Owner Information Address Phone Cell
GABRIELA MEKLER 1130 NE 91 Terrace (305)323-5464
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
PINO'S PROFESSIONAL PLUMBING It (305)323-2455
of Work: REMOVAL OF APPROX. 35' OF CONCRETE
of Piping:
onal Info:
Return :
ification: Residential Scanning: 3
Fees Due
Amount
CCF
$4.20
DBPR Fee
$4.50
DCA Fee
$3.00
Education Surcharge
$1.40
Permit Fee
$300.00
Scanning Fee
$9.00
Technology Fee
$5.60
Total:
$327.70
Valuation: $ 7,000.00
Total Sq Feet: 0
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL-6-18-67772
06/06/2018 Credit Card $ 277.70 $ 50.00
06/01/2018 Credit Card $ 50.00 $ 0.00
mvauaoie inspections:
Inspection Type:
Top Out
Final
Review Plumbing
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: 11:a �fyl that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction andygnin9. Futh l authorize the above -named contractor to do the work stated.
June 06. 2018
,Cut tforized-Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
June 06, 2018 1
Miami Shores Village
� g p Buildin De artment REc�''�CI
f 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 JUN
Tel: (305) 795-2204 Fax: (305) 756-8972
\ INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20r1�
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No.
❑ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 113 171
City: Miami Shores County: a�ctc_ Miami Dade Zip: 3313
Folio/Parcel#: i (' 3,�aS- 6o) - 0q I o Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
/
OWNER: Name (Fee Simple Titleholder): �G�1� I6il etc, �� �� i� Phone#: 3C5S"
Address: t ClAc e l
City: i'/ !I CLWI I �� t^�� State: (� Zip: 3313 9
Tenant/Lessee Name: i(�/� Phone#:
r
Email: ►� ^7�/�^
CONTRACTOR: Company Name: FYI() plutti bll olt/ Phone#: dur" 3.13'�( /yJ
Address: l3 y� S f� �` I°iCcGe
City: State: L Zip:
Qualifier Name:._,41-pvc U10 u 1 Phone#:
State Certification or Registration #: C �G� 1 alR 3 Certificate of Competency #:
DESIGNER: Architect/Engineer: ,/r%�� Phone#:
Address: City: State: — Zip:
Value of Work for this Permit: $ / 6yio, Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New 19 Repair/Replace Demolition
f1 i
Description ofWork:.Izfmx(j 0- I 36 0,C Ci ocie Siajj To Rf/3I4c Old C4sf
Specify color' of color thr`u tile:
Submittal Fee $ Permit Fee.$
Scanning Fee $ - Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ 1
(Revised02/24/2014)
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.
OWNER or AGENT
The fo4regoing instrument was acknowledged before me this
day ofM ci 2010 K by
l�Gbt fr Iv AA-rtI-c who is personally known to
me or who has produced P. b C as
identification and whQATtake an oath.
NOTARY PU
Sign:L—f—,ol�
Print: 049'"l
Signature •
CONTRACTOR
The foregoing instrument was acknowledged before me this
SO -91 day of _ 20 1 b by
AI fv Ft r1 O who is personally known to
me or who has produced TDL SOD 000 3-4 Lj q y() as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: Q IM G I,f kyil 00_rJ T
Seal: =. V Notary Public -State of florlda Seal:
Commis ion N FF 973302 Notery Public State of Florida
.; ''•4% ..�.•'��, My Comm. E pints Mar 21, 2020 ;p aris Hemandez
�
DamMyCommisalonFF *** *************
APPROVED BY "�J �o Plans Examiner Zoning
Structural Review
Clerk
(Revised02/24/2014)
Miami -Dade Official Records - Print Document
Page 1 of 3
Prepared by:
Steven M. Liberty, Esq.
Nexterra Law
1691 Michigan Avenue, #360
Miami Beach, Florida 33139
Record and Return to:
Focus Title Group, LLC
2600 Douglas, Rd., Suite 717
Coral Gables, FL 33134
Parcel No.: 11-3205-001-0410
SPACE ABOVE THIS LINE FOR PROCESSING DATA
CFN: 20180324367 BOOK 30998 PAGE 1450
DATE:06/04/2018 09:20:15 AM
DEED DOC 5,355.00
HARVEY RUVIN, CLERK OF COURT, MIA-DADE CTY
SPACE ABOVE THIS LINE FOR
WARRANTY DEED
This WARRANTY DEED is made the J I_ day of May, 2018, between BARBARA TER
HORST, a married woman, Individually and as Trustee of THE BARBARA TER HORST TRUST
U/A/D 11/19/10 as Amended and Restated on June 13, 2017, joined by her husband, HANS WERNER
BECKERT, whose address is 5525 Bannergate Dr., Alpharetta, GA 30022, hereinafter called the
Grantors, and GABRIELA MEKLER, a married woman, whose address is 1130 NE 91 Ter., Miami
Shores, FL 33138, hereinafter collectively called the Grantee.
The Grantors, for and in consideration of the sum of $10.00 and other valuable consideration,
receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises, releases, conveys
and confirms unto the Grantee the below -described land situated in the County of Miami -Dade, Florida:
Lot 16 and W V. of Lot 17, Block 2, of WATERSEDGE, according to the plat thereof,
as recorded in Plat Book 9, Page 141, of the Public Records of Miami -Dade County,
Florida.
Also known as 1130 NE 91 Ter., Miami Shores, FL 33138.
TOGETHER WITH all the tenements, hereditaments and appurtenances thereto belonging or in
anywise appertaining. Subject to taxes for the year 2018 and subsequent years, restrictions, reservations,
covenants and easements of record, if any, but this shall not serve to reimpose same.
TO HAVE AND TO HOLD the same in fee simple forever. And the Grantors hereby covenant
with the Grantee that the Grantors are lawfully seized of said land in fee simple, that the Grantors have
good right and lawful authority to sell and convey said land and that the Grantors hereby fully warrant the
title to said land and will defend the same against the lawful claims of all persons whomsoever. Grantors
further warrant that said land is free of all encumbrances, except as noted herein and except taxes accruing
subsequent to December 31, 2017.
A
https://www2.miami-dadeclerk.comIPublic-Records/PrintDocument.aspx?QS=YaoUfOzxry... 6/6/2018
Miami -Dade Official Records - Print Document
Page 2 of 3
written.
CFN: 20180324367 BOOK 30998 PAGE 1451
In Witness Whereof, the Grantors have executed this warranty deed the day and year first above
Signed, sealed and delivered in our presence:
Witness:
Printed No k5410- L11 - � ARA TER H ST,
Individually and as Trustee of THE
BARBARA TER HORST TRUST
U/A/D 11/19/10 as Amended and
_.= Restated on June 13, 2017
Witness:
Printed Nam .
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
The foregoing instrument was acknowledged before me thisl. day of May, 2018 by BARBARA
TER HORST, Individually and as Trustee of THE BARBARA TER HORST TRUST U/A/D 11/19/10
as Amended and Restated on June 13, 2017, who is personally known to me or produced the following
identification: F` 0�
Mcgia—ryth bIic
,erEVEN �welnv
0" weft . NO a flalds
Co�Usim • 00 424500
• Ur Comm. ExOmo Au0 25. 2020
kib10M11opti Wontfo1.Y bte.
[CONTINUED ON NEXT PAGE]
Page 2 of 3
https://www2.miami-dadeclerk. com/Public-Records/PrintDocument. aspx?QS=YaoUfOzxry... 6/6/2018
Miami -Dade Official Records - Print Document
Page 3 of 3
Witness: _
Printed N e: _. 4-ta
Witness:
Printed Name: tCa
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
CFN: 20180324367 BOOK 30998 PAGE 1452
{ANS WERNER BECKERT
The foregoing instrument was acknowledged before me this 1,7',qday of May, 2018 by HANS
WERNER BECKERT, who are personally known to me or produced the following identification:
L 0�-
Notfiy Public
•�;ri:1N "EVEN LIBERTY
2' Notary PUNC - SWO dl Florida
CoaN'sm" 0 00 024589
MY COMM. Eaolna Aup 25. 2020
kMbdtkoup VAVW MmaryABU.
Page 3 of 3
https://www2.miami-dadeclerk.com/Public-Records/PrintDocument.aspx?QS=YaoUfOzxry... 6/6/2018
13841 SW 25 Terrace
MIAMI, FL 33175
PH # 305-323-2455
CFC 1427235
DATE: 5/25/18
State of Florida
County of Dade
Before me this day personally appeared L&x FFw O'bbeing duly sworn,deposed and says:
That he will be the only person working on the project located at: 1130 NE 91 Terrace
/Contractor signature
Sworn to (or affirmed) and subscribed before this 31 day of May 2018
Personally know. -X-
Or produced identification
Type of identification produced
Print type o stamp name of notary
?ot►R;P�B��, MANUELAHIDAL
* * Commission # GG 131971
Expires August 6, 2021
o,n. eane.�tniuet�e�ne�s Page �
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Notice t,6 owner }- Workers' Compensation Insurance Exemption
*: 4-.-«. -*7-.:'"
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:
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:
Owner
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this day of
By � I_�Y who is personally own to me or has produced
i1i
r U l )v. ,I kYI 1 N rti f' as identification.
Notary Public - State of Florida
Commission N GG 069765
My Comm. Expires Feb 5, 2021
OMB Approval No. 2502-0265
A. Settlement Statement (HUD-1)
1. ❑ FHA 2. ❑ RHS 3. ❑ Conv. Unins.
6. File Number:
7. Loan Number:
8. Mortgage Insurance Case Number:
FTG-1"058JC
4. ❑ VA 5. ❑ Conv. Ins.
C. Note: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agents are shown. Items marked
•(p.o cr were paid outside the closing; they are shown here for informational purposes and are not included In the totals.
D. Name & Address of Borrower:
E. Name & Address of Seller:
F. Name & Address of Lender.
Gabdela Mekler
BARBARA TER HORST TRUST
1130 NE 91 TER, Miami Shores, FL 33138
G. Property Location:
H. Settlement Agent:
I. Settlement Date: O5d2312018
1130 NE 91 Terr.
Focus Title Group, LLC
Disbursement Date: 05/23/2018
Miami Shores, FL 33138
8950 Fontana Del Sd Way, Suite 100. Naples, Florida 341
Tel: 239-331-5100
Place of Settlement:
TitleExpress
8950 Fontana Del Sol Way, Suite 100. Naples, Florida 3410c
Printed 05/2 V2018 at 11:03 am
by JC
J Summary of Borrower's Transaction
r
103. Settlement charges to borrower (line 1400) 6,160.50
104.
Ad' stments for items paid by seller in advance
106. Cityltown taxes to
107. County taxes to
108. Assessments to
109. Non -Ad Valorem Taxi 05/23/2018 to 09/30/2018 258.59
110.
111,
112.
120. Gross Amount Due from Borrower 898,919.09
200. Amounts Paid by or In Behalf of Borrower
201. Deposit or earnest money 93,50D.00
202. Principal amount of new loan(s)
203. Existing I s taken subject to
204.
206.
207.
208.
209.
Adjustments for items unpaid by seller
210. Cityltown taxes to
211. County taxes 01101/2018 to 0502018
212. Assessments to
213.
216.
217,
218.
219.
220. Total Paid by/for Borrower 96,235.76
300. Cash at Settlement fromfto Borrower
301. Gross amount due from borrower (line 120) 898,919.09
302. Less amounts paid by/for borrower pine 220) 96,235.76
303. Cash ❑X From ❑ To Borrower $02,683.33
Na Mw. aNw II e4M • cwmUr •aio ONB cenetl nvMar Ne mnrgweiaVM n aaweV: Via JWewn,a inrga,ory
feNaogrll preoex
Summary
Se ler's Transanon
.K.
of
400. Gross Amount Due to Seller
401.
Contract sales price
892,500.00
432.
Personal property
403.
404.
405.
Adjustments for items paid by seller in advance
406.
Cityltown taxes to
407.
County taxes to
408.
Assessments to
409.
Non -Ad Valorem Tax( 05/2312018 to 09/30/2018
258.59
410.
411.
412.
420.
Gross Amount Due to Seller
$92,759.59
500.
Reductions In Amount Due to Seller
501.
Excess deposit (see instructions)
502.
Settlement charges to seller (line 1400)
51,725.00
503.
Existing loa s taken subject to
ram•
Payoff of first mortgage loan #68218019262399 to
Bank of America
11,767.09
505.
Payoff of second mortgage loan
506.
507.
Disbursed as proceeds ($93,500.00)
508.
509,
Adjustments for items unpaid by seller
510.
CityAown taxes to
511.
County taxes 01/01/2018 to 05232018
2,735.76
512.
Assessments to
513.
514,
515.
516.
51T
518.
519.
$20.
Total Reduction Amount Due Seller
66,227.85
600.
Cash at Settlement Wrom Seller
601.
Gross amount due to seller line 420)
892.758.59
602,
Less reductions in amount due seller (line 520)
66,227.85
603.
Cash 0 To ❑ From Seller
826,530.74
to pre•ii IM pars.. q � RESpa oe•raV Venaanbn wM� iNermaVon Am,q Vr
Previous editions are obsolete Page 1 of 3 HUD-1
L. Settlement Charges
700. Total Real EstO Broke Fm $ 44,625.00
Paid From
Borrower's
Funds at
Settlement
Paid From
Seller's
Funds at
Settlement
�
- ^'�+ofcommission (line as
701. $17,850.00 to Douglas Elliman
702. $26,775.00 to ACC Realty, Inc.
703. Commission paid at settlement
44,625.00
$00. trams Payable In Connection with Loan
801. Our origination charge (Includes Origination Point 0.000%or $0.00) (from GFE #1)
802. Your credit or charge (points) for the specific interest rate chosen S (from GFE #2)
803. Your adjusted origination charges (from GFE A)
804. Appraisal fee to from GFE #3
805. Credit report to from GFE #3
806. Tax service to from GFE #3
907. Flood certification to from GFE #3
808. to
900. Ifems Roquired by Lender to be Paid In Advance
901. Daily interest charges from from 05/2312018 to 0 0112018 @ $0.00/day (from GFE #10)
902. Mortgage insurance premium months to from GFE #3
903. Homeowner's insurance months to from GFE #11
904, months to from GFE #11
1000. Reserves DitoosIM with Land
1001. Initial deposit for your escrow account (from GFE #9)
1002. Homeowner's insurance months @ $ /month
1003. Mo a insurance months 0 $ Imonth
1004. Property taxes months @ $ Imonth
1005. County taxes months @ $ 586.01Imonlh $
1006. Assessments months Q $ 0.001month $
1007. Aggregate Adjustment $
1100. Tilde Charges
1101. Title services and lender's title insurance from GFE #4
1,250.00
1102. Settlement or dosing fee to Focus Title Group, LLC $1.250.00
1103. Owner's the insurance - North American Title Insurance Company $ from GFE #5
4,537.50
1104. Lender's title insurance - North American Tide Insurance Company $
1105. Lender's title policy limit $0.00 Lender's Policy
1106. Owner's title policy limit $892,500.00 Owners Policy
1107. Agent's portion of the total title insurance premium $3,176.25
to Focus Title Group, LLC
1108. Underwriter's portion of the total title insurance premium $1,361.25
to North American Title Insurance Company
1109. Lien Search to Reliable Lien Search
245.00
1110. Tide Search to TideWrite Solutions, Inc.
143.00
1111. Title Surcharge to North American Title $
Insurance Company
1200. Government Recording and Transfer CharW
1201. Government recording charges $ (from GFE #7)
18.50
1202. Deed $18.50 Mortgage $ Release $
1203. Transfer taxes $ (from GFE 08)
1204. Documentary Stamps Deed Deed $5,3W..00 Mortgage $
5,355.00
1205. Documentary Stamps M19 Deed $ Mort $
1206. Intangible Tax Deed $ Mongage $
1207 E-recording Fee
4.50
1208. E-recording Fees
9.00
1209. Record Cert of Trust and NOC
88.00
1300. Additional settlement Charges
1301. Required services that you can shop for (from GFE #6)
1302. Survey to Target Surveying, LLC
350.00
1303. Adomeys Fees to Nexterra Law
1,000.00
1304. Wire Fees to Focus Title Group, LLC
60.00
1305. Utilities Escrow to Focus Title Group, LLC
200.00
6,160.50 51,725.00
'Paid outside of dosing by (B)orrower, (S)eller, (L)ender, (I)nvestor, Bro(K)er "Credit by lender shown on page 1. "'Credit by sel'er shown on page 1.
t. :
Previous editions are obsolete Page 2 of 3 HUD-1
HUD CERTIFlCATIDN OF BUYER AND SELLER
1 KeNe —killf —4we0 tM HUOI SSOYmml StIMmrM aM b 01s best of my b o ilm," stt0 DWN, O is a In» am i aousab sYbtmsnt OI as —,"s wO
OaWasmmY 111sM m mY a(Ydln1 er by me m IM Vuuatlion. I k~ mMy trot 1 hi Ne wime0 a COPY of me 11UO•t Sal/erneM SYtmNM.
Garwa Moller
Im Miuua
I, ■Pull,
tNUO1 SSOYmeM StmemeM rsNUI I hmm W psn0 of a Vms an0 tbt . a1sY1YK of me, trineeogm I IIeNs M%d V NM cauaa IN, Mas b be
O sixm W m acmfaa— MIN, blibmmt.
SETTLEMENT AGENT
DATE
WARNING.: IT IS A CRIME TO KNOWINGLY asAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM PENALTIES UPON
CONVICTION CAN INCLUDE A F0IE AND IMPRISONMENT FOR DETAILS SEE TITLE 18 U S CODE SECTION 1001 AND SECTION 1010
Pre—mlbms ary Ot—I.. Pa0e 3 .13 MUD-1
MUD CERTIF"TION OF BUYER AID SELL@t
III.r.co.ltwy ItAftd fti HUD4 SOOMMM SmmwR wd to M..w of wT NIVYftEq wd Ww. I Is rI Md.MLM fwWwo a•nakw wd
mw. ftm.e.-I.T.mmMa by AI.MMbY.Int11m.I%~—"TwI h--.h... wwy a Ow INat SWMM ftM
&WWM TER HORST TRUST
7Ir HUa1 S."~SWW-KMMI h—pl.pw.CA.IAr wIo ra.w..omu.a Se r.rs.rim. I LID.. —"or wma SrAM to IM
"0.,W NO.oacft a Wl ft Fwtw.wk
SETTIEIffM AGENT
5 'p -J,
DATE
WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STAT IAMTS TO THE UNTED STATES ON THIS OR ANY SYMR FORM PENALTIES UPON
CONVICTION CAN INCLUDE A FINE AND WRISONMZM. FOR DETAILS SEE TITLE 15 U$. COX SECTION 1001 AHD SECTION 1LHO.
P-Ab *Mons w. ob. F.0. 3 a 3 HAD-1
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND
PROFESSIQ, AL REGULATION
CFC1427235 SU50: 09/08/2016
-X
CERTIFIED PLOP ING;:� fJ[ ACTOR
PING, ALEX
PINO'S PROFESS0NNG INC.
IS CERTIFIED under the provisions of Ch.489 FS.
Expiration date : AUG 31. 2018 L1609080002922
J
Local Business Tax %cei pt
M iam i-Dade County, State of Florida
-THIS IS NOT BILL -DO NOT PAY
7184908
BUSINESS NAM E/LOCATION
P1NO'S PROFESSIONAL
PLUMBING INC.
13841 SW 25 TERR
MIAMI, FL 33175
OWNER
PINO'S PROFESSIONAL PLUMBING
INC.
r./n Al PX PINn
Worker(s) 1
RECEIPT NO. EXPIRES
RENEWAL SEPTEMBER 30, 2018
7465684
Must be displayed at place of business
Pursuant to County Code
Chapter BA - Art. 9 & 10
SEC. TYPE OF BUSINESS
196 PLUMBING
CONTRACTOR
CFC1427235
PAYMENT RECEIVED
BY TAX COLLECTOR
82.50 10/16/2017
0222 18 0
This local Business Tax P=aipt 0, ;y con°rms Local
00183
pernit, or a certi ^cation of the holder's quali,,captioons todo buss ness, Holdersrr st cTne llcei pt is not a license,
or nongovernmpp y to the business
entai regulatory laws and require=rIts which a Y with any governrrental
.
umbBk
The RdMPT NQ above must be displayed on ali ccrtrr�ercial vehicles - Miam Dade Cave Sec-
MIAMILL&DE
wr,y; For nrore information, visit w� rriani dada rov/ aY dl ertor
JEFF ATWATER
CHIEF FINANCIAL OFFICER STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
* * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law.
EFFECTIVE DATE: 11/10/2016 EXPIRATION DATE: 11/10/2018
PERSON: PINO ALVARO J
FEIN: 464524893
BUSINESS NAME AND ADDRESS:
PINO'S PROFESSIONAL PLUMBING INC
13841 SW 25 TERRACE
MIAMI FL 33175
SCOPES OF BUSINESS OR TRADE:
LICENSED PLUMBING
CONTRACTOR
Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section
may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only
within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be
exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate,
the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a
DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609
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NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO. 1)-3,,Q0S-Da ( -0� JD
STATE OF FLORIDA:
COUNTY OF MIAMI-DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
of property and
2. Description of Improvement:
v _�11C 915"'
CFN 201�-IR1-13223u2
OR BY, 30997 Ps 113 (1F9s)
-RECORDED 06101 /2i11g 1 1 :04 � i 1,
HARVE Y RUV'N p CLER'K. OF COURT
MIAi1I--DADE COUNTY? FLORIDA.
Space above reserved for use of recording office
C
3. Owner(s) name and address: `
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name, address and phone number: 12-_ )c �' .1A /1
36S
5. Surety: (Payment bond required by owner irom contractor, if any)
Name, address and phone numbeFMA�,
Amount of bond $ 4tk r
6. Lender's name and address I G�Rf�Y ih fi this is a true c Y of fdtb 2tiP^ . L,,
7. Persons within the State of Florida designated by Owner upon whom a cumtsnts may be server u d
Section 713.13(1)(a)7. Florida Statutes,{' s
Name address and hone number: ✓v /� N9i15L'Sf�
p a nun' Caurfs
B. In addition to himself, Owners designates the following persons) to r� a Lienor's Notice as provided in
713,13(1)(b), Florida Statutes, �/
Name, address and phone number: -�
9. Expiration date of this Notice of Commencement:
(the expiration date Is 1 year from the date of recording unless a different date Is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK
OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Signature( nenh,
(s r Ow r s ' uthorized Officer/Director/Partner/Manager
Prepared B ' Prepared By �R%'�� /C?,4gc �
Print Name ' Print Name gam'/ , r__r
Title/Office YTitle/Office ,A1,9 /r464� RU(i
STATE OF FLORIDA
COUNTY OF MIAMI-DADE L
The forpgging insstfument"-yr Fe-}nras p1no eged before me this day of A t i�
❑ Individually, or ❑ as for
❑ Personally known, or J01-roduced the following type of Identific I • f • % C,
Signature of Notary Public:
MARIA Print Name: ?mot 1 '? �'' Z
f flOrida
(SEAL) �� �.= Commission #f FF 973302
VERIFICATION PURSUANT TO SECTION 92.525, FLORIDA STATUTES
Under penalties of perjury, I declare that I have read the foregoing and
that thMif
stated in it are true, to the best of my knowledge and belief.
Si� Owne.S(s�orJ Oyineh(s),'s Authorized Officer/Director/Partner/Manager who signed above:
My Comm. Expires Mar 21, 2020
123_01-5T9AGE3 V2