EL-19-1832Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
I;D
Issue Date: 08/07/2019
Location Address Parcel Number
1411 NE 103RD ST, Miami Shores, FL 33138 1132050310140
Contacts
Permit NO.: EL-08-19-1832
Permit Type: Electrical - Residential
Work Cfassificatron: Service Change
Permit Status: Approved
Expiration: 04/22/2020
HANI EID Owner
GR ELECTRICAL SERVICE INC Contractor
ALEJANDRO GOMEZ
5471 W 8 LN, HIALEAH, FL 33012
Business: 3058648885 alegomez2@outlook.com
Inspection
Description: REPLACE EXISTING OVERHEAD SERVICE FOR NEW Valuation: $ 2,500.00 Requests:
4949
ONE
Total Sq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.80
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.60
Permit Fee
$50.00
Scanning Fee
$9.00
Technology Fee
$2.50
Total:
$117.90
Payments
Date Paid Amt Paid
Total Fees
$117.90
Cash
08/07/2019 $50.00
Credit Card
10/25/2019 $67.90
Amount Due:
$0.00
Building Department Copy
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 all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent
Date
October 25, 2019 Page 2 of 2
BUILDING
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
REC❑'ATV , D
A G 07 "019
BY.
fr' (_T- 1
1�
FBC 20 I�
.__.� ICU_ () I141€ ()z
Master Permit No.
PERMIT APPLICATION
❑BUILDING X ELECTRIC ❑ ROOFING
Sub Permit No.
❑ REVISION ❑ EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
.0
City: Miami Shores County: Miami Dade Zip: 33 13
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): TCc.VII I C Phone#:
Address: 1 T r, Fg d �,,1 T
City: 0 ✓-eS State: L Zip: 3 313 $
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: 69 � L f �i(� V Phone#: — >�— =L
Address:
City: l.4 Zit State:
� �_ Zip:
Qualifier Name: l& 1 o_�f�/Ut-1� 7 (® L4Ate Z� Phone#:
State Certification or Registration #: r (� c� (}� I Certificate of Competency #:
DESIGNER: Architect/Engineer:
ne#:
Address: City: State: /Zip:
Value of Work for this Permit: $ T -A 6. [� Square/Linear Footage of Work: /U/�
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work, ' ' e av ,
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Permit Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $_
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $ `A� • 010
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. in the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
40
Signature Signature
WNER or AGENT 11—�TRACTOR
The foregoing instrument as acknowledged before me this
w c�
} day c \ 120 f q, by
E I k who is personally known to
me or who has produced --t X as
identification and who did take an oath.
NOTARY PUBLIC:
Print: PUBUC
F-FL-6W�
Seal: Cmnrn# GG011579
Expires 7/13/2020
The foregoing instrument/ws acknowledged before me this
day of J I l 1 20 r q by
A'p� 1A 64fAt! who is personally known to
me or who has produced f�c�/$dylel(� �t>/Gtt.'%L as
identification and who did take an oath.
NOTARY PUBLIC:
0'e�<
r ScWecld
Sign:
Print: 1 t
Seal: �EVIM 7/13/=
Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)
American Land Title Association ALTA Settlement Statement - Combined
Adopted 05-01-2015
File No./Escrow No.:
FTG-19-0121
Print Date & Time:
07/17/2019 04:13 PM
Officer/Escrow Officer:
Jessica Concepcion
Settlement Location:
Focus Title Group, LLC
6609 Willow Park Drive, Second
Naples, Florida 34109
6609 Willow Park Drive, Second, Naples, Florida 34109
Property Address: 1411 NE 103 Street, Miami Shores, FL 33138
Buyer: Hani M. Eid, Maya C. Eid
Seller: Jose Guilherme Aitken, Eva Maria Lis
Lender: Bank of America
Settlement Date: 7/22/2019
Disbursement Date: 7/22/2019
Additional dates per state requirements:
Seller
Description
Borrower/Buyer
Debit
Credit
Debit
Credit
Financial
$730,000.00
Sales Price of Property
$730,000.00
Deposit
$73,000.00
Loan Amount
$584,000.00
Proration/Adjustments
County Taxes from 7/22/2019 to 9/30/2019
$146.96
County Taxes from 1/1/2019 to 7/22/2019
$3,073.99
$146.96
County Taxes from 7/22/2019 to 9/30/2019
$3,073.99
County Taxes from 1/1/2019 to 7/22/2019
Loan Charges to BOA
Origination Fee to BOA
$730.00
Appraisal Fee to Corelogic:
$532.00 POC-Borrower
Credit Report to Corelogic:
$27.31 POC-Borrower
Flood Cert Fee to Corelogic
$5.00
Life of Loan flood mon. to Corelogic
$8.00
Tax Service to Corelogic
$79.00
LenderCredits to Bank of America
$(2,920.00)
Other Loan Charges
Settlement Fee to Focus Title Group, LLC
$1 250.00
Survey Fee to M.E. Land Services, Inc.
$350.00
Homeowner's Insurance Premium to Typ Tap
Management Company
$6,716,00
Flood - Personal to Raposo Ins. Group
$2 194.49
Copyright 2015 American Land Title Association.
All rights reserved.
Page 1 of 3
FTG-19-0121
Printed On: 07/17/2019 04:13 PM EST
Seller
Description
Borrower/Buyer
Debit
Credit
Debith
Prepaid Interest to Bank of America
$580.00
Impounds
Homeowner's Insurance 3 mo @
$548.61
182.87/mo
Title Charges & Escrow / Settlement Charges
Lender's Policy with North American Title
$3,395.00
Insurance Company
ALTA 8.1 EPL $25.00
$25.00 Buyer
FL Form 9-Simul $375.00
$375.00 Buyer
Owner's Policy with North American Title
$755.00
Insurance Company
Commission
$14,600.00
Real Estate Commission Sellers Broker to ACC
Realty, Inc.
$21,900.00
Real Estate Commission Buyers Broker to
COMPASS
Government Recording and Transfer Charges
Documentary Stamps Mtg to Focus Title
$2,044.00
Group, LLC
Intangible Tax to Focus Title Group, LLC
$1,168.00
Recording Fees (Deed) to Focus Title Group,
$18.50
LLC
Recording Fees (Mortgage) to Focus Title
$171.50
Group, LLC
$4,380.00
Documentary Stamps Deed to Focus Title
Group, LLC
Payoff(s)
$383,964.71
Lender: Payoff of First Mortgage Loan to
DiTech
Principal Balance as of 8/1/2019
$383,964.71
Interest on Payoff Loan: -10 days @
$0.00/day for $0.00
Miscellaneous
E-recording to Focus Title Group, LLC
$9.00
$130.00
Violations to Miami -Dade County Code
Enforcement
$750.00
Attorneys Fees to Focus Title Group, LLC
$245.00
Lien Search to Reliable Lien Search
$125.00
Title Search to North American Title
Insurance Company
$60.00
1
1 Wire Fees to Focus Title Group, LLC
Seller
Borrower/Buyer
Debit
Credit
Debit
Credit
$429,228.70
$730,146.96
Subtotals
$747,249.06
$660,073.99
Due From Borrower
$87,175.07
$300,918.26
Due To Seller
$730,146.96
$730,246.96
Totals
$747,249.06
$747,249.06
Copyright 2015 American Land Title Association.
All rights reserved.
Page 2 of 3
FTG-19-0121
Printed On: 07/17/2019 04:13 PM EST
Acknowledgement
Well have carefully reviewed the ALTA Settlement Statement and find it to be a true and accurate statement of all
receipts and disbursements made on my account or by me in this transaction and further certify that I have received
a copy of the ALTA SettlemejrA Statement. Well authorize to cause the funds to be disbursed in accordance with this
statement. )
Hani Eid U
4*
May . Eid `
Jose Guilher a Aitken
r
o
va Mari
t� OWN
wl
NOTARY PUBLIC
STATE OF FLORIDA
Conm# GG011579
Expires 7N3!20i20
Copyright 2015 American Land Title Association. FTG-19-0121
All rights reserved. Page 3 of 3 Printed On: 07/17/2019 04:13 PM EST
ACORON CERTIFICATE OF LIABILITY INSURANCE
08/06/2� o 9
THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed.
H SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on
this certificate does not confer rights to the certificab holder In lieu of such endorseme s .
PRODUCER
Kjv Insurance Agency
2652 SW 87th Ave
Miami, FL 33165
Phone 305 227-9856 Fax 305 227-8961
NWCT
PHONE (305)227 8956 (No: {305)227-8961
ADDREas: juanitaaau@yahoo.com
INSURERS AFFORDING COVERAGE
NAIC •
INSURER A; Ascendant Commercial Insurance, Comp.
INSURED
GR ELECTRICAL SERVICES, INC
14262 SW 140 ST SUITE # 118
MIAMI, FL33186
INSURER is: Lloyd's of London
INSURER : Ascendant Commercial insurance, Comp.
INSURERD: Gurad Insurance, Comp.
INSURERE:
INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR LTR
TYPE OF INSURANCE
L
Pq�Y NUUSER
POLICY
Ery
LIMITS
A
VP
COMMERCIAL GENERALLU1BAJTY
CLAIMS -MADE a OCCUR
Y
Y
NPP1432934
01/27/2019
01/27/2020
EACHOCCURRENCE
$ 1,000,000.00
77
DAMAGE TO REP4TEIT_
PREMISEESEr oxmetrcsl--
MEDExp(Any ome )
-f 100,000.00
$ 5,000.00
PERSONA. a ADV INJURY
S 1,000,000.00
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY ❑ JPERa LOC
OTHER:
GENERAL AGGREGATE
i 2,000,000.00
PRODUCTS - COMP/OP AGG
t 2,000,000•00
$
B
AUTOMOBILE
LIABILITY
ANY AUTO
AOWNED UTOS ONLY SCHEDULEDAUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
CA-31291-1
12/26/2018
12/26/2019
COMBINED SINGLELIMIT
$ 1000000.00
S
I—
BODILY INJURY (Par person)
BODILY INJURY (Per acddant)
S
PROPERTY DAMAGE
Px aoddent
$
pip
$ 10,000.00
C
UMBRELLA LIAS OCCUR
EXCESS LIAS CLAIMS -MADE
DED f RETENTION
Y
TMAIWD
02/19/2019
02/19/2020
EACHOCCURRENCE
s 3,000,000.00
AGGREGATE
$ 3,000,000.00
S
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRIETORIPARTNERIEXECUTTVE YIN
OFFICER/MEMBEREXCLUDED7 Y❑
(Mands" In NH)
Mayes esorlbe under
IPTION OF OPERATIONS
N!A
Y
GRWC64774
03/03/2019
03/03/2020
po
STATUTE ETH
E.L. EACH ACCIDENT---
$ 500,000.00
s 500,000.00
E.L. DISEASE - EA EMPLOYEE
I E.L. DISEASE - POLICY LIMIT
$ 500,000.00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Addtlo" Remarks SetwAda. rimy be attached N more span b n qulrad)
ELECTRICAL CONTRACTOR. LICENSE # EC13007301
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
10050 N.E. 2ND AVENUE
MIAMI SHORES,FL 33138
SHOULD ANY OF THE ABOVE DESCRIE
THE EXPIRATION DATE THEREOF,
ACCORDANCE WFrH THE POLICY PROI
AUTHORIZIED REPRESEN TATiVE
M BE CANCELLED BEFORE
WILL BE DELIVERED IN
01986-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD