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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