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1065 NE 96 St (8);UILDING LECTRICAL 'LUMBING w .. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE 194_ PERMIT N? 6512 Work to be performed under this Permit )weer of 3uilding 'architect Contractor's License No. , ontractor sr Builder .egal Lot Bl. 5ubdi- Jescription vision address of Value of Amt. of 3uilding Project Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli- •ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any Awls, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked it any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this iermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and egulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed: By INSPECTOR 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 )ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. n accepting this permit I assume responsibility for a work done by either myseE, my agent, servant or employee. BY AUTHORITY ;UILDING LECTRICAL 'LUMBING GOOFING MIAMI SHORES VILLAGE. FLORIDA PERMIT N? 6157 ?wner of wilding architect , ontractor )r Builder .egal Lot 9 iddress of luilding CONTRACTOR OR BUILDER Work to be performed under this Permit Subdi- vision Value of Project $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application .erefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans 4rawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any tine if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is !ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations , ertaining to'the work covered hereby whether shown on the plans or drawings ,or in the ¥fatements or specif� }ions and tli he assumes responsibility for work one by his agents, servants or employees. Signed. DATE Contractor's License No. 195_x' Amount of Permit $ BY • INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hejeunder in compliance with all ordinances and regulations , ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac• opting this permit I assume responsibility for all work done by either, myself, my agent, servant or „employ / ee. J BY "AUTHORITY 6 n MIAMI SHORES VILLAGE BUILDING INSPECTILAN DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. ` // Owner's Name and Address ._.. - 4 �� -- 4� Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision State work to be done and purpose of building (by floors) Street and Number where work is to be done Date /.0 / /— No._ 06' Street and for no other purpose. New Building Remodeling Addition Repairs ) No. of Stories To be constructed of Kind of foundation Roof Covering t Estimated Total cost of improvements $ 4E* �? Amount of Permit $ Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hint in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcon ractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks ( Signed) � � L.. ' STATE OF FLORIDA, COUNTY OF DADE. j ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No Date Read, Sworn to and Subscribed before me. Disapproved Date Notary Public, State of Florida (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chainnan Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. ELECTRICAL INSPECTION DEPARTMENT r c� r/ � .7 APPLICATION FOR ELECTRICAL PERMIT Permit No j ` ( 1 Date Ma.r.ch...3,....19.7.2... ..... Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Donald Zern Registered Architect and /or Engineer Employing Electrician's Name Dominix Electric, Inc:. STATE OF FLORIDA, COUNTY OF DADE. I "' MIAMI SH111RES VILLAGE No No 14010 1065 Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) /6'0 New Building Remodeling .ems Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation— Conduit Tubing B.X.I: Metal Moulding Amount of Permit S (Signed)...1�`' Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of FI. da Permanent Supplement, and has complied with the provisions thereof, and will require similar cornpliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection o e site of t e w such public \ notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, work to . . ffornud un this permit, as are licensed by Miami Shores Village. Street N. E. 96 Street Street N . W . 19 Avenue Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facto therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG R ECE'P'7'S FIXTURES N O. LAMPS REFRIG. OUTLET IRON O UTLET RANGE OUTLET RANGE CONN. WATER H EATER W. H EAT. CONN. SPACE H EATER STRIP H EATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 141 HP N EON TRANS. RADIO TOTAL CONTR. LIST 5c/5 � hi , _ To CHECK ELECTRICAL INSPECTION DEPARTMENT r c� r/ � .7 APPLICATION FOR ELECTRICAL PERMIT Permit No j ` ( 1 Date Ma.r.ch...3,....19.7.2... ..... Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Donald Zern Registered Architect and /or Engineer Employing Electrician's Name Dominix Electric, Inc:. STATE OF FLORIDA, COUNTY OF DADE. I "' MIAMI SH111RES VILLAGE No No 14010 1065 Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) /6'0 New Building Remodeling .ems Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation— Conduit Tubing B.X.I: Metal Moulding Amount of Permit S (Signed)...1�`' Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of FI. da Permanent Supplement, and has complied with the provisions thereof, and will require similar cornpliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection o e site of t e w such public \ notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, work to . . ffornud un this permit, as are licensed by Miami Shores Village. Street N. E. 96 Street Street N . W . 19 Avenue Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facto therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Permit No. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Registered Architect and /or Engineer Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss' MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date Employing Electrician's Name ) - . e No. - Location and Legal Description Lot___ 1421 L__( ° Street and Number where work is to be performed—No./ 6 5- State work to be performed and purpose of building (By Floors) New Building Remodeling Addition 0 a Service Overhead Size Feeders_e1,__1 Conduit.__ Main Sw.al ' / ' I Amps Main Fuses__ ___________Amps. Underground — Type of Installation— Conduit Tubing w_ B.X.L. .Metal Moulding (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on ink to be performed under this permit, as are licensed by Miami Shores Village. (Signed �--�— No 42` Street___ ,2 Street Repairs My Commission Expires Notary Public. State of Florida ° S ubdivision__ — _ No. of Stories______ –•-s— Master Electrican. Before me. the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the____________ - _____ _ of the above described construction. that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLLEppTS LIGHT OUTLETS PLUG RECE'P'T's FIXTURES NO.LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CL STR 2,_,..p , / / / / / / a, CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL. CONTR. LIST CHECK Permit No. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Registered Architect and /or Engineer Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss' MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date Employing Electrician's Name ) - . e No. - Location and Legal Description Lot___ 1421 L__( ° Street and Number where work is to be performed—No./ 6 5- State work to be performed and purpose of building (By Floors) New Building Remodeling Addition 0 a Service Overhead Size Feeders_e1,__1 Conduit.__ Main Sw.al ' / ' I Amps Main Fuses__ ___________Amps. Underground — Type of Installation— Conduit Tubing w_ B.X.L. .Metal Moulding (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on ink to be performed under this permit, as are licensed by Miami Shores Village. (Signed �--�— No 42` Street___ ,2 Street Repairs My Commission Expires Notary Public. State of Florida ° S ubdivision__ — _ No. of Stories______ –•-s— Master Electrican. Before me. the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the____________ - _____ _ of the above described construction. that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. BUILDING ELECTRICAL PERMIT N? 6512 ti Contractor's PLUMBING Lie n e No. " � � Lie 1 Owner of Building Architect Contractor/ or Builder/ 4 �! Work to be .pe formed under this Permit //t' Legal Legal Lot - Bl. Description Address of Building // :1;1 �! MIAMI SHORES VILLAGE, FLORIDA DATE /7 Subdi- vision BY AUTHORITY ; � 1/ Value of Amt.4E� - ��` Project Permit ; LI This permit is granted to the contractor or builder named above to construct the building or to install the equipment or evice described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be perfonned in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition.0 on which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge oftKe inances and sibility for work done by his he wok servants hereby whet er shown on the plans o / drawi or in th��tatements or ��ifications and that h jass nes respon- Signed: l'v - ' 0 ' - --- B = r INSPECTOR consideration of the issuance to me of this permit I agree to Reiform the work covered hereunder in compliance with_ all ordinances nccj�eggu�l1�tions :Vm`a pertain g thereto and in strict conformity with the plans, drawingsstatements or specifications submitted to the proper authorities of Miami In accepting this permit I sume responsibility for all work done by either myself, my agent, servant or employee. A ' 1 , ' /I.9 V '- CTOR OR BUILDER BUILDING ELECTRICAL ?LUMBING Ow ter of Building 7 7/ Architect Contractor or Builder �! Legal Lot Description V PERMIT N? 6382 Address of / �j' // ' f Value of Amt. of- r cation herefor in strict compliance Building /�, , �" C � , ,��, :' — .// �� Project Permit �---�� This permit is granted to the contractor h all on plans, drawings, statements or rations t] at any time if the work is not done in compliance permit is granted is the understanding that the contractor or builder named above assumes the responsibility r a thorough knowledge of therdinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the staten its or specifications and he.assurnes respon- sibility for work done by his agents, servants or employees. i / Signed: i b Work to be performed under this Permit $l: n : .Q NTRA CR BU I4. . MIAMI SHORES VILLAGE, FLORIDA Subdi- vision BY DATE e�t? _J J' • �." l ( Contractor's Lice° se No. SR ECTOR +" "r f AUTHORITY 194 consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and Jegguula ons pertainidg thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Sh&.&.:Vililige. In ac pting this pern}it I assume responsibility for all work done by either myself, my agent, servant or employee. t'; DAVE BOSWORTH MANAGER FLORIDA POWER & LIGHT COMPANY MIAMI, FLORIDA Mr. John D. Hansell Building & Zoning Director Electrical Department Village of Miami Shores Miami Shores, Florida Dear Mr. Hansell: DB:ns Enclosures (2) June 3, 1948 Yours very truly, Dave Bosworth, District Manager. Replying to your letter of May 28th con- cerning the pole now located in the driveway at 1065 N. E. 96th Street, this is to inform you that I have issued an order to have this pole removed and hope we will be able to get the work done within the next few days. I am taking the liberty of enclosing herewith, for your information; copy of a letter that was written to all electrical contractors in the greater Miami area, asking their cooperation with my Company, and which letter I believe is self - explanatory. I thought you would be interested in this matter and your cooperation with us in this regard will be greatly appreciated as you know the long time we were unable to obtain meters and many elec- trical contractors got into the habit of cutting services across without meters and without at the same time, notify- ing our Company, which naturally caused us a lot of concern and extra work. Permit No._ A la Dated ' ,( Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. " ^ 0 Owner's Name and Address __ Pi - ' MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT LIGATION FOR ELECTRICAL PERMIT No. __ e - _ Registered Architect and /or Engin r _ _ — ____�_ _ _-- ________ —_— I /C n1 o � _ — (�/7 Employing r:l . Name .i‘ �> A ^ �� `\ � %.:.- _ " =��. No.- -- �-r-- t - ---- Street � , n �� C Block Subdivision ____ —__________________________ Street Location and Legal Description Lot Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Service Overhead Size Feeders Underground Amps. Type of Installation— Conduit Tubing B.X.L Metal Moulding 0 -2..4 Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss' My Commission Expires Conduit. Main Sw. n ,l The undersigned applicant for this building permit does hereby ce under the Florida Workmen's Compensation Act, being Section 5966, plied with the provisions thereof, and will require similar compliance performed under this permit: and will post or cause to be posted for required by the Act. The under signed agrees to employ only such licensed by Miami Shores Village. Addition.. Repairs (Signed) Electrical Inspector. rtify that he understands and accepts his obligations as an employer of labor Compiled General Laws of Florida Permanent Supplement, and has com- froln all contractors or sub - contractors employed by him in the work to be inspection on the site of the work such public notice or notices as are sub - contractors, on work to be performed under this permit, as are (Signed) the undersigned authority, a notary public, duly authorized to administer Notary Public. State of Florida No. of Stories Main Fuses_ —____ _____—___Amps. T Master Electrican. " Before me, appeared _ to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is ____ of of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. oaths and take acknowledgments, personally NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO.LAM PS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE H EATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP M OTORS 1 -3 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK Permit No._ A la Dated ' ,( Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. " ^ 0 Owner's Name and Address __ Pi - ' MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT LIGATION FOR ELECTRICAL PERMIT No. __ e - _ Registered Architect and /or Engin r _ _ — ____�_ _ _-- ________ —_— I /C n1 o � _ — (�/7 Employing r:l . Name .i‘ �> A ^ �� `\ � %.:.- _ " =��. No.- -- �-r-- t - ---- Street � , n �� C Block Subdivision ____ —__________________________ Street Location and Legal Description Lot Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Service Overhead Size Feeders Underground Amps. Type of Installation— Conduit Tubing B.X.L Metal Moulding 0 -2..4 Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss' My Commission Expires Conduit. Main Sw. n ,l The undersigned applicant for this building permit does hereby ce under the Florida Workmen's Compensation Act, being Section 5966, plied with the provisions thereof, and will require similar compliance performed under this permit: and will post or cause to be posted for required by the Act. The under signed agrees to employ only such licensed by Miami Shores Village. Addition.. Repairs (Signed) Electrical Inspector. rtify that he understands and accepts his obligations as an employer of labor Compiled General Laws of Florida Permanent Supplement, and has com- froln all contractors or sub - contractors employed by him in the work to be inspection on the site of the work such public notice or notices as are sub - contractors, on work to be performed under this permit, as are (Signed) the undersigned authority, a notary public, duly authorized to administer Notary Public. State of Florida No. of Stories Main Fuses_ —____ _____—___Amps. T Master Electrican. " Before me, appeared _ to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is ____ of of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. oaths and take acknowledgments, personally NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Page 2 IMPORTANT NOTICES AFFIDAVIT - Please read carefully. Print Name Sworn to and subscribed before me this SEAL: WO. Type of Identification Produced: Y •F MIAMI -DADE too � Expires Aovetnber 15, 2008 DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD.' Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. •• • • Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER otte propet;ty,,crertify drat Ali: work will be performed to meet the standards of all laws regulating construction in this jurisdiction. Iunderstand th'ai cepal'ate pelDlijs,. are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WI 1 )4, FENCE, DRIVEWAY,• • ROOFING and SIGNS and there may be additional permits required from other governmental agencItA, • I'. • • •: • • .•• •••• • . I, the OWNER of the property, have disclosed all information related to any work at the property j elformed � Co& prior muse months to the Building Official. Further, I am fully aware that if the cumulative cost of work to myJ} g e pr business. under thr's•ar+d any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, th . dtire strut t ,must meee�l present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of.work to my I;grug or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structures +tstlsj. conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: PERMIT APPLICATION Personally known OR, Produced Identification (f Personal) own OR, Produced Identification Y b) s pe f I tification Produced: PROPERTY OWNER Al �,/ ° me Enclosure Address / �_ , Q ' f L Home Telephone (..... �57 / 607 Business Telephone /QiGCI / / 5..z : G.eC, �C Fax C 1 Orn, r A Relocation of Structure TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other Step 1. Job Address: .• INSTRUCTIONS - The following steps must be taken to obtain a permit from the Nliami Shores Village: Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. A I'PLICA'f1ON • •. •• • • • • • "PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other /o GS A/1 74 Address • •• • • • Jaip Number • • • •••• Z 8 . J-At • : r c • B�oc is Apt. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax e ription of Work Master Permit No PERMIT APPLICATION Subsidiary Permit No. ./y'9' 2 City /- foie, 33/3 g State _ Zip li $Lbdivision .... • • PB PG Caisreat Use of Property Square Feet Units Floors • • •••• ad • P • . ed • Use of eperty • • • • ak e of Work ••.• .tenant Information • T Assessed/Appraised Value • .. Flood Zone Base Floor Elev. • • • • Zoning Linear Feet Bldg Value ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name ELECTRICAL '1'1'1'1. Minimum Fee QTY. TYPE Dryer QTY. TVI'1? Outlet, Appliance (1'1'1'. = TVI'1? Service Repair Q'I'1'. Refrigeration, Tons Vent Hood, Cost 0 C Central:Tons • ' A7t” �'aWWin. Tons Miscellaneous Repairs Dryer Vents, Number of Solar Water Heater Paint Booth A/C Central 1 -3 Ton >< Fan 6 Outlet, Wall Outlet, Switch ---- 3,2 Service, Temporary Signs Piping, Flammable Liquid A/C Central 4 -7 Ton Periodic Inspections Fire Pump A/C Central 8 -15 Ton Pump and Abandon Fixture - Fluorescent 3 Oven / Space Heater (kw) Gas - Appliance A/C Central 16-20 Ton Pump, Domestic Fixture Light G Parking Lot Lights Cap - Sewer Spas/Hot Tubs Gas - Natural A/C Central 20+ Ton Pump, Fire Stand Flood Lights FPL - Load Central V 2� 2 Plugmold/Strip Posts Catch Basin Subfeeds, No. of Amps Swim Pool, Commercial Gas - Propane A/C Window Air Conditioners Garbage Disposal Range/Range Top / Swim Pool, Residential Chiller „, - .. Generators, etc. Receptacles Switchboards Clear Violafofs • • • •. Heat Recovery Refrigerator, Comm. (p/PH) Refrigerator, Domestic — 7 — Temp Serv., Construction Temp for Test - 30 days •EAmlactor •••• • • • • Low -volt, Burglar ,I i p,Freez!r • • • • • Low -volt, Fire Indirect Wastes Renew - Temp Service Relay Repair Vacuum Pump • • Uemoltion • Disposal Low -volt, Intercom/Teleph. Interceptor Repair Circuits Roof Inlet Water Closet bishwasher • • • • • • • j(• • Low -volt, Television Laundry Tray Service, Number of Amps 2, e 0 Water Heater MECHANICAL T1'1'1. Q ?'Y. TYPE QTY. TYI'I'. QTY. '1'm.: Q I'Y. r3ihlifium Fee • .• • • Condensate Drain ;Cooling Tower QTY. Generator Heating Strips, each Q"1'1'. Refrigeration, Tons Vent Hood, Cost 0 C Central:Tons • ' A7t” �'aWWin. Tons Miscellaneous Repairs Dryer Vents, Number of Solar Water Heater Paint Booth Bidet Ventilation, Cost Filter Replace Air Handler, Tons Pool Piping Ductwork, Cost of Sprinkler Repair Piping, Flammable Liquid Cap - Fixture Periodic Inspections Fountain Barbecue Pump and Abandon Fire Sprinkler System Sprinkler System Process/Pressure Piping Cap - Water Gas - Appliance Bath Fan - Vented, # Pump, Domestic Fireplaces, Number of Supply, AC Well Pressure Vessel Cap - Sewer Gas - Natural PLUMBING TYPE A/C Condensate Q'I'1'. TYI'1. Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYI'1: Soakage Pit Q"1'1'. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply • • Page 3 • • • • • •• • RECEIVED AND REVIEWED BY: PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. %% llATE: /01241:9 Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) $ 6 (� 0 Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine Zoning Review Notary O PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) Cl OTHER (Specify & Attach) $ SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE (x .6. x/1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) •• •• .. • • • • • PER \1IT FEES • • • • • .. •• • • •• • • .•.• • • • • • • • • • • . • ••• • • •. • • • • • ••• • •••• • • • • • • • • .• TOTAL $ ISSUING OFFICIAL CONDITION OFAPPRONAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com • • Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 4/17/2003 Applicant: JOANNE IN 1Z Owner: -EERAI of ' Gk y\ JOB ADDRESS: 1065 NE 96 Contractor Local Phone: Parcel # 1132060143700 -Tk c c� Total Fees: velw Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 10/14/2003 Construction Value: $500.00 Work: REWIRE THE WHOLE HOUSE If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. This Permit is granted to ^teaL3:ation herefor in strict compliance with all ordinances pertaining therel and approved by the proper authorization. A further con ordinances and regulations by his agents, servants or e Signe Signed In consideration of the is with the plans, drawings, sl myself, my agent, serva viioa eE Zt's 31Va L LC9/CV -C9 /' clap tE9/EV8 -E9 G y_ ti'L£Z Electrical Permit Permit Number: EL2003 -101 - rnar)g deANNE 1\1;cK ST Contractor's Address: Legal Description: MIAMI SHORES SEC 3 PB 10 - 37 LOT 11 & W1/2 LOT 10 BLK 82 LOT SIZE `I 2 052f b20 b`t :'OfhbOtE90:1 .40 xi/ f wee }sna y ;nos 110:1 3oflcno3Hl 01 AVd 8£L££ '1d 'Salogg !UIBTw l 4 1 96 3 ICIS90L VZOMLL80 U VQNI'I Page 1 of 1 9ications that may have been submitted to or if the plans are changed without lonsibility for a thorough knowledge of the that he assumes responsibility for work done g ins pertaining thereto and in strict conformity responisibility for all work done by either B. Type of Loan 1. ❑ FHA 2. ❑ FmHA 3. ❑ Conv.Unins 4. ❑ VA 5. • Conv.lns. 6. File Number 02.028 7. Loan Number DC3OTS68 8. Mortgage Insurance Case Number C. Iota This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "1p.o.c.)" were paid outside the closing; they are shown here for information purposes and are not included in the totals. D. Name and Address of Borrower Nicolas H. Marian, III and Linda D. Ortigoza 1065 N.E. 96 Street, Miami Shores, Florida 33138 E. Name and Address of Seller Ronald Scott Zern and Joanne K. Zern 255 East Gurley, Suite 100 40 North Central Avenue,Suite 1500 Prescott, Arizona 86301 Phoenix, Arizona 85004 Name and Address of Lender Bankers Mortgage Trust, Inc. National City 13790 N.W. 4 Street, 11 106 P.O. Box 6570 Sunrise, Florida 33325 Cleveland.Ohio 44101 G. Property Location 1065 N.E. 96 Street, Miami Shores, Florida 33138 H. Settlement Agent Robert B. Ely, Esq. I. Place of Settlement Eagle Realty 9063 Biscayne Boulevard Miami Shores, Florida 33138 I. Settlement Date December 27, 2002 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION: 100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER 101. Contract Sales Price S 389,000.00 401. Contract sales price S 389,000.00 102. Personal property 402. Personal property 103. Settlement charges to borrower (line 1400) S 12,314.99 403 104 404 105 • • • • 405. • • Adjustments tr ilell paid by seller in advance Adjustments for items paid by seller in advance 1 106. Ctyltown t s' • • • to • ' 406. Cityltown taxes to y : Al t& untytaxeslo' IOlitdmi•DadeCount *Tax C ollector S 50.48 407. County taxes to Miami•Dade County Tax Collector S 50.48 08. Assessments • to 408. Assessments to • • . • .• • • - -.. 409. .4411 •.• • 110D 4444 -- 410. ••. • • 1 111 • • • •••• 411. ;112•; • 412 • •••• 7 110. GROSS AMOCO DUE FROMVO§iRO P ER S 401,365.47 420. GROSS AMOUNT DUE TO SELLER S 389,050.48 • x f80! AMOUNTS PAID BY OR ON BEHALF or BORROWER ;� 00. REDUCTIONS IN AMOUNT DUE TO SELLER 201. Deposit or earnest money i 0 000 rQ . .01. Excess Deposit (see Instructions) 202. Principal amount of new loan from Bankers Mortgage S ` ;,000.00 502. Settlement charges to seller (line 1400) S 35,354.02 203. Existing loanls) taken subject to 503. Existing loan(s) taken subject to 2044a,.v( o� 73,500.00 504. Payoff of first mortgage loan J 205 505. Payoff of second mortgage loan 206 506 207 507 208. 508 209 509. Adjustments for items unpaid by seller Adjustments for items unpaid by seller 210. Cityltown taxes to 510. Cityltown taxes to 211. County taxes to 511. County taxes to 212. Assessments to • 512. Assessments to 213 513 214 514 215 515 216 516 217. 517 218 518 219 519 220. TOTAL PAID BYIFOR BORROWER S 379,500.00 520. TOTAL REDUCTION AMOUNT DUE SELLER S 35,354.02 300. CASH AT SETTLEMENT FOR OR TO BORROWERS 600. CASH AT SETTLEMENT TO OR FROM SELLER 301. Gross amount due from borrowerlline 120) S 401,365.47 601. Gross amount due to seller (line 420) S 389,050.48 302. Less amounts paid bylfor borrower (line 220) S 379,500.00 602. Less reduction amount due seller (line 520) S 35,354.02 303. CASH FROM BORROWER S 21,865.47 3 . ASH TO SELLER S 353, "16.46 ft. Settlement Statement la 3 °�'f 3 0� U.S. Department of Housing and Urban Developement OMB No. 2502 -0265 5s6 C4 " REV:HUD•1 (3186) ENDFIELD vj - L. 0E11 Lunen' i unanritS PAID FROM PAID FROM SEL'S FUN AT SETTLEMENT 700. TOTAL SALESIBROKER'S COMMISSION based on price S 389,000.00 x 5% = S 19,450.00 BO FUR ROWER'S NDS AT Division of commission (line 700) as follows: SETTLEMENT 701. S 19,450.00 to Eagle Realty 702. S to 703. Commission paid at Settlement 19,450.00 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fee: FIELD(67) % 802. Loan Discount: FIELD(68) % 803. Appraisal Fee to: Bankers Mortgage Trust, Inc. S 275.00 804. Credit Report to: Bankers Mortgage Trust, Inc. S 60.00 805. Lender's Inspection Fee to 806. Mortgage Insurance Application Fee to 807. Assumption Fee to 808. Document Preparation fee to: Bankers Mortgage Trust, Inc. S 195.00 809. Tax Service Fee to: Bankers Mortgage Trust, Inc. $ 60.00 810. Processing Fee to: Bankers Mortgage Trust, Inc. S 300.00 811. Underwriting fee to: Bankers Mortgage Trust, Inc. S 225.00 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest from 112712002 to 11112003 @ S 49.331day S 246.65 902. Mortgage Insurance Premium for to 903. Hazard Insurance Premium for 1 year to ¢°( F L. "`„ r V,nioNee Se40.,V K .S , aV e., $ 859.00_ S 2,704.00 904. Windstorm Insurance Premium for 1 year to FAr Ns 0d?-t yC. S. a)Cs yO C 1000. RESERVES DEPOSITED WITH LENDER " 1001. Hazard Insurance 3 months @ $ 71.581mo. S 214.74 1002. Mortgage Insurance mo. @ S Imo. 1003. City property taxes mo. @ S Imo. 1004. County property taxes 3 momths @ S 358.751mo. S 1,076.25 1005. Annual aoses•ment• mo. ° Q i Imo. • • 3006.• mt. r : Imo. 1001. Windstorfh1nmCb 3 months @ S 225.331mo. S 675.99 !008. Aggregate Adjustment $ 0.00 • ; 11.I0.TITLE CIiARGfi. • • • • •tW /Settlement fee to RdbErTltlEly, Esq. $ 125.00 • 1162 Abstract or t iIg torch to AUdhf2ps • fjle Insurance Fund, Inc. S 190.00 : •title exanii ation td' Robert B. Ely Mi. $ 125.00 • 1104.1itle insurance binder to d • :f10 . bocument preparation to •1106. Notary fees • to 1107. Attorney fees to Steven L. Jones, Esq. S 1,200.00 (includes above items No: 1 1108. Title insurance to Attomeys Title Insurance Fund, Inc. S 2,070.00 (includes above items No: 1 1109. Lender's coverage S 296,000.00 1110. Owner's coverage S 389,000.00 1111. Second Mortgagee coverage S 73,500.00 1112. Endorsements 2 Alta 8.1, 2 Florids 9, 1 AME S 489.00 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording fees: Deed S 12.00; Mortgage $ 60.00 and S 60.00; Assignment of Mortgage S 10.50 S 142.50 1202. Citylcounty tax/stamps Deed $ ; Mortgage S 1203. State taxlstamps: Deed S 2,334.00; Mortgage S 1,036.00 and S 257.25 S 1,203.25 S 2,334.00 1204. Intangible taxes on Mortgages S 592.00 and S 147.00 739.00 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey to Nova Surveyors, Inc. S 225.00 1302. 2002 Real Property taxes to Miami•Dade County Tax Collector S 4,605.87 1303. Flood Certificate Fee to Bankers Mortgage Trust, Inc. S 29.50 1304. Courier fees to Bankers Mortgage Trust, Inc. S 75.00 1305. Wire Funding fee to Bankers Mortgage Trust, Inc. S 100.00 1306. Lien Search to A•1 Title Support Services, Inc. S 95.00 1307. Tank removal, septic tank pumpout to Bioex Corporation S 7,329.15 1308. Reserve for Water, Lien Bills S 150.00 1309. Courier, Fedex, Delivery S 100.00 1400. TOTAL SETTLEMENT CHARGES (enter on lines 103 and 502, Sections J and K S 12,314.88 S 35,354.02 - CETI ' va rAv RW f R Rt} oTm t tf f .4 lj ,` accoun disburs b, me in this tran ccount ge 11111111131111T, it is a true an accura statement of all receipts and ction. I further certify that I have recei a c13 ar f HU 1 Settlement Statement. i ArriM Borrowers To the best of my knowledge , e HUD.1 Settlement Statemen hich I have prepared is a true and accurate disbursed by the undersigned as part of the settlement of this transaction. S ers U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT PAGE 2 the funds which were received and have been or will be Settlement Agent Date WARNING: It is a crime to knowingly make also statements to the United States on this or any similar form. Penalties upon convictions can include a fine or imprisonment. For details see: Title 18:U.S. Code Section 1001 and Section 1010. REV:HUD -1 (3186) LSS 0190.2 • ADDENDUM Date urate statemen o a e es o my . o ge and b eli ef , i t i s a true and acc ll L. SETTL receipts an in this transa ion. I further certify that I have receiv copy f H • Settlement Statement. Borrowers - Sel •:rs To the best of my knowledge , the H 1 Settlement Statement w ich I have prepared is a true and accurate acco disbursed by the undersigned as part of the settlement of this transaction. U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT PAGE 2 funds which were received and have been or will be Settlement Agent WARNING: It is a crime to knowingly make false statlamoots to the United States on this or any similar form. Penalties upon convictions can include a fine or imprisonment. For details see: Title 18:U.S. Code Section 1001 and Section 1010. REV:HUD -1 (3186) LSS 0190.2 PAID FROM BORROWER'S FUNDS AT SETTLEMENT PAID FROM SELLER'S FUNDS AT SETTLEMENT 700. TOTAL SALES/BROKER'S COMMISSION based on price 8 Division of commission (line 700) as follows: 701. S to 702. S to 703. Commission paid at Settlement 704. 0 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fee: 802. Loan Discount: 803. Appraisal Fee to: 804. Credit Report to 805. Lender's Inspection Fee to 806. Mortgage Insurance Application Fee to 807. Assumption Fee to 808. 809. 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest from to @ S Iday 902. Mortgage Insurance Premium for to 903. Hazard Insurance Premium for yrs. to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance mo. @ S Imo. 1002. Mortgage Insurance mo. @ S Imo. 1003. City propgrgy tyros mo. @ S Imo. 1004. bounty property lo i x es o. 2•S• • Imo. • • lib' Annual assessment. mC. @ S • Imo. ••1061* • ••• . mc: @.$ : Imo. • "S • • • 1007. • mo L Imo. 1.11Q6• • . •• - • • • mo• 6 8 • Imo. • • 11V TITLE CIingES 'IV gettlemen!ere1e14 fee • jp • • •1402! Rbstract or tit search • .tg • • • a).1atle examinatjD4 .. • .ta ... 104. Title insuryraert der • to • • • 406.Oocument preparation • to • 1106. Notary fees to 1107. Attomey fees to (includes above items No: ) 1108. Title insurance to S (259.00) (includes above items No: ) 1109. Lender's coverage S 1110. Owner's coverage S 1111. 1112. 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording fees: Deed S ; Mortgage S ; Releases S 1202. City/county taxlstamps Deed S ; Mortgage S 1203. State taxlstamps Deed S ; Mortgage S 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey to 1302. Pest inspection to 1303. Mortgage Broker Fee on 2nd mortgage S 500.00 P.O.C. 1304. Recording, document taxes, settlement charges S (500.00) 1305. 1400. TOTAL SETTLEMENT CHARGES (enter on lines 103 and 502, Sections J and K CERTIFIMILIALAReve carefully reviewed the HUD•1 Se tt l ement Statamant a nd to th b t f •-•'� S (759.00) S 0.00 • ADDENDUM Date urate statemen o a e es o my . o ge and b eli ef , i t i s a true and acc ll L. SETTL receipts an in this transa ion. I further certify that I have receiv copy f H • Settlement Statement. Borrowers - Sel •:rs To the best of my knowledge , the H 1 Settlement Statement w ich I have prepared is a true and accurate acco disbursed by the undersigned as part of the settlement of this transaction. U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT PAGE 2 funds which were received and have been or will be Settlement Agent WARNING: It is a crime to knowingly make false statlamoots to the United States on this or any similar form. Penalties upon convictions can include a fine or imprisonment. For details see: Title 18:U.S. Code Section 1001 and Section 1010. REV:HUD -1 (3186) LSS 0190.2 Wigrrr4 • • - • • • • • • • -**Cf*7,77`,. •7119 " :. • r • • • • • • • • • • • • • • ••• •• • • ----- tate The Sunshine S •-•- uc egsevas osEs 0 50428- 61-252.0 t8COCAAS ti SAMO MS NW 10114 pVE PAWS, Ft. Vo20662 Woos so vat nest esoottse 0712-61 frO9 otrota9) EYPIRES DUPLICATE 0742'04 01-10-01 BAK DRIVES testmosofedbv"": • • Grantee #28S!fio. • • • • • •• "Pr6Qerty Applajsej's Parcel I nti*ation No. 11- 3206 - 014 -3700 • • THIS INSTRUMENT PREPARED BY: Steven L. Jones, Esq. 9999 NE 2nd Ave., Ste. 216 Miami Shores, FL 33138 RETURN TO: Robert B. Ely, Esq. PO Box 57 -0155 Miami, FL 33257 Grantee #1 S.S. No. •••• • • •• •• •• • • •. • • ••• • • •••• •• 4A •; rjl,S !NDEMTURE, made tllit �d' day of .i961-E,6(A- 20 e'L between RONALD SCOTT ZERN, a muriettman, whose post • office address is 255 Eastndrley, Suite 100, Prescott, AZ 86301, grantor *, and NICOLAS H. MARIAN, III, a single man, and LINDA •;'D.•ORTIGOZItit •singlefubblan, whose post office address is 1065 NE 96th Street, Miami Shores, FL 33138, grantee *, • • • T ruV1NESSETH that said • g for and in consideration of the sum of Ten and 00/100 ($10.00) Dollars, and other good and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is herby acknowledged, has granted, bargained and sold to the said grantee, and grantee's heirs and assigns forever, the following described land, situate, Tying and being in Miami -Dade County, State of Florida: Lot 11 and the West '/Y of Lot 10, Block 82, MIAMI SHORES, SECTION NO. 3, according to the Plat thereof, as recorded in Plat Book 10, at Page 37, of the Public Records of Miami -Dade County, Florida. SUBJECT TO (1) land use designation, zoning restrictions, prohibitions and other requirements imposed b governmental authorites; (2) restrictions, easements and other matters apearing on the plat and /or common to the subdivision; (3) public utility easements of record which are located contiguous to the property lines; and (4) taxes for the year 2003 and subsequent years. The above - described real property is not the homestead of grantor, nor is it adjacent to or continguous with any homestead property of grantor or any relative thereto. and said grantor does hereby fully warrant the title to said land, and will defend the same against lawful claims of all persons whomsoever. * "grantor" and "grantee" are used for singular or plural, as the context requires IN WITNESS WHEREOF, grantor has hereunto set grantor's hand and seal the day and year first above written. Signed, -- -d, and delivered in our presence: (Fiist it ess) Printed : typed name. Ake tYYN4- (Se cq(d Witness) Printed or typed name: u t ■ e- -(Alf A STATE OF ARIZONA COUNTY OF Vmm - pA/ THE FOREGOING INSTRUMENT was acknowledged before me this rI day of / , 20 OkTby RONALD SCOTT ZERN, ama�ryir 1 man, who is (or are) personally known to me or who has (have) produced N C / f as identification, and who did (did not) take an oath. My commission expires: • • • • • OFFICIAL SEAL BREE M. GATES Notary Public - State of Arizona YAVAPAI COUNTY ■1 , C. m. E: pres Dec. 17, 2003 nri.P,EC.EK. 20909PG0542 WARRANTY DEED 02R8 16636 2002 DEC: 30 16t22 ---7 RONALD SCOTT ZER'J 7oRDEO IN OFNL N'- RECOKOS £ - .;ADE COUNTY, FLORIDA. coRD VERIFIED HAP VEY RUVIN p.dosl sf Cf Nam Notary ru • ic, State of- fee (Seal) GO T- /2 &A: .� 1 ecgc -82 • • . • .. • • • • •••• ...... • .' • • • 5582 N.W. 7th STREET, SUITE 202 MIAMI FLORIDA 33126 TEILEPHONE: (305) 2642660 FA*:(306)264- 9 • • • Tom- /' 'J • • •••• • . ... • • • .. • • Nuna frurui3�rii Sur. LAND SURVEYORS • • .. • • • i BOUNDARY SURVEY scale 1" = 00' 1e97 —// IJGe� BZ • a /S, 05' 7W0 ..0 7-0,2 y' /2& /0 65 dK 2¢ 70' 20 LO -/0 I D oT- /O ,&z0eiz 41.4.0 Ae- .4 SURVEY NO. O2- /'7 / ✓Z SHEET NO. OF . ft HIN , y 1 G' *s t L 1 s r, : #°:09: , 0 T ' 1 z s + 3 a. i OICRI n r. tip- �; „s ,� .. ` 9 , 0 T ' 1 z - 3 s 1I4 t 1 N t ! 11O Z 6562 N.W. 7th STREET, SUITE 202 MIAMI, FLORIDA 33126 TELEPHONE: (306) 284-2860 FAX (305) 284.0229 DRAWN BY: Nona Attruniani e lan LAND SURVEYORS SURVEY No. SHEET NO. 2- 0014932• , OF Survey of The West %2 of lot 10 and all of lot 11 in Block 82 Subdivision: MIAMI SHORES SECTION NO 3 According to the Plat thereof as recorded in the Plat Book No. 10 at Page No. 37 of the public records of MIAMI -DADE County, Florida. Property Address: -1065 NE 96 ST, MIAMI SHORES, FL 33138 For: NICOLAS H. MARIAN,III A . ARC. NC . AIR CONDITIONER PAD. A.E.. ANCHOR EASEMENT. A/R . ALUMINUM ROOF. NS . ALUMINUM SHED. ASPH.. ASPHALT. B.C.. BLOCK CORNER. BLDG.. BUILDING. B.M.. BENCH MARK. B.0.B.. BASIS OF BEARINGS. C.. CALCULATED. C.B. ■ CATCH BASIN. C.B.S.. CONCRETE BLOCK STRUCTURE. CBW . CONCRETE BLOCK WALL CH.. CHORD DISTANCE. CH. B.. CHORD BEARING. CL . CLEAR. C.LF.. CHAIN UNK FENCE. C.M.E.. CANAL MAINTENANCE EASEMENT. CONC.. CONCRETE. C.P.. CONC. PORCH. C.S. • CONCRETE SLAB. D.E.. DRAINAGE EASEMENT D.M.E.. DRAINAGE MAINTENANCE EASEMENT. DRIVE.. DRIVEWAY. o . DEGREES. E.. EAST. E.T.P.. ELECTRIC TRANSFORMER PAD. ELEV.. ELEVATION. ENCR..ENCROACHMENT. F.H.. FIRE HYDRANT. F.I.P.. FOUND IRON PIPE. F.I.R.. FOUND IRON ROD. F.F.E.. FINISHED FLOOR ELEVATION. LOCATION SKETCH Scale 1" = I 1 1 1 1 1 1 1 •T L 1 ABBREVIATIONS AND MEANING F.N.D.. FOUND NAIL & DISK FR.. FRAME. FT.. FEET. FNIP.. FEDERAL NATIONAL INSURANCE PROGRAM. F.N.. FOUND NAIL H.. HIGH (HEIGHT). IN. & EG.. INGRESS AND EGRESS EASEMENT. L.P.. UGHT POLE. LF.E.. LOWEST FLOOR ELEVATION. LM.E.. LAKE MAINTENANCE EASEMENT. ' . MINUTES. M.. MEASURED DISTANCE. MON.. MONUMENT. MA-I.. MANHOLE M/L.. MONUMENT UNE. N.A.P.. NOT A PART OF. NGVD. NATIONAL GEODETIC VERTICAL DATUM. N.. NORTH. N.T.S.. NOT TO SCALE. * - NO.. NUMBER. 0/S.. OFFSET. OH.. OVERHEAD. O.H.L. OVERHEAD UTILITY LINES OVH.. OVERHANG. O.R.B.. OFFICIAL RECORD BOOK. PVMT.. PAVEMENT. PL . PLANTER. - P/L.. PROPERTY UNE. P.C.C.'• POINT OF COMPOUND P.R.C.. POINT OF REVERSE CURVE. PROP. COR.. PROPERTY CORNER. P.B.. PLAT BOOK. PG.. PAGE. PWY . PARKWAY. PRM . PERMANENT REFERENCE MONUMENT. P.L.S.. PROFESSIONAL LAND SURVEYOR. R.. RECORDED DISTANCE. RR.. RAILROAD. RES.. RESIDENCE, RAN.. RIGHT -OF -WAY. RAD.. RADIUS OR RADIAL R.P.. RADIUS POINT. ROE.. RANGE. SEC.. SECTION. STY.. STORY. SWK.. SIDEWALK. S.I.P.. SET IRON PIPE L.B. *6044 S. • SOUTH. S.N.D.. SET NAIL & DISK LB.*6044. SP.. SCREENED PORCH. ". SECONDS. T.. TANGENT. TWP.. TOWNSHIP. U.E. UTIUTY EASEMENT. UTIL . UTILITY. U.P.. UTIUTY POLE. W.M.. WATER METER. W.F.. WOOD FENCE. W.S.. WOOD SHED. CURVE. A. CENTRAL ANGLE. P.C. • POINT OF CURVE. W.. WEST. PT.. POINT OF TANGENCY. PO ? C.. POINT OF COMMENCEMENT Y • CENTER LINE. POE.. POINT OF BEGINNING. 4. . ANGLE. LEGAL NOTES TO ACCOMPANY SKETCH OF SURVEY (SURVEY): EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THE PROPERTY. THIS SURVEY IS SUBJECT TO DEDICATIONS, UMITATIONS, RESTRICTIONS, RESERVATIONS OR EASEMENTS OF RECORD. LEGAL DESCRIPTIONS PROVIDED BY CUENT OR ATTESTING TITLE COMPANY. BOUNDARY SURVEY MEANS A DRAWING AND/OR A GRAPHIC REPRESENTATION OF THE SURVEY WORK PERFORMED IN THE FIELD. COULD BE DRAWN AT A SHOWN SCALE AND/OR NOT TO SCALE. EASEMENTS AS SHOWN ARE PER PLAT BOOK. UNLESS OTHERWISE SHOWN. THE TERM 'ENCROACHMENT MEANS VISIBLE AND ABOVE GROUND ENCROACHMENTS. ARCHITECTS SHALL VERIFY ZONING REGULATIONS, RESTRICTIONS AND SETBACKS AND THEY WILL BE RESPONSIBLE OF SUBMITTING PLOT PLANS WITH THE CORRECT INFORMATION FOR THEIR APPROVAL FOR AUTHORIZATION TO AUTHORITIES IN A NEW CONSTRUCTION, UNLESS OTHERWISE NOTED, THIS RRM HAS NOT ATTEMPTED TO LOCATE FOOTINGS AND/OR FOUNDATIONS. FENCE OWNERSHIP NOT DETERMINED. THIS PLAN OF SURVEY, HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF THE ENTITIES NAMED HEREON, THE CERTIFICATE DOES NOT EXTEND TO ANY UNNAMED PARTY: THE FNIP FLOOD MAPS HAVE DESIGNATED THE HEREIN DESCRIBED LAND TO BE 0.00 Situated in Zone: X Community /Panel /Suffix: 120652 - 0093 -3 Date of Firm: 07/17/1995 Base Flood Elevation: Certified to: NICOLAS H. MARIAN,III AND LINDA D. ORTIGOZA ROBERT B. ELY, ESQ ATTORNEY'S TITLE INSURANCE FUND,INC BANKERS MORTGAGE TRUST, .INC., ITS SUCCESSORS AND /OR ASSIGNS NATIONAL CITY, ITS SUCCESSORS AND /OR ASSIGNS Date: 12/18/2002 ILL 1• C`.7 • N� s SO•F 9 •• •• • • • • • • • ••• LEGEND TYPICAL. • • SURVEVORS'S NOTES: 1) IF SHOWN, BEARINGS ARE REFERRED TO AN ASSUMED MERIDIAN, BY SAID PLAT IN THE DESCRIPTION OF THE PROPERTY. IF NOT, THEN BEARINGS ARE REFERRED TO COUNTY TOWNSHIP MAPS. 2). IF SHOWN, ELEVATIONS ARE REFERRED TO B.M.* ELEV OF N.G.V.D. OF 1929. 3). THIS IS A SPECIFIC PURPOSE SURVEY. 4). THE CLOSURE IN THE BOUNDARY SURVEY IS ABOVE 1:7500 FT. I HEREBY CERTIFY: THAT THIS 'BOUNDARY SURVEY' OF THE PROPERTY DESCRIBED HEREON, AS RECENTLY SURVEYED AND DRAWN UNDER MY SUPERVISION, COMPUES WITH THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL LAND SURVEYORS IN CHAPTER 61017.6, FLORIDA ADMINISTRATIVE CODE PURSUANT TO 472.027, FLORIDA STATUTES. BY: IBARRA (DATE OF PROFESSIONAL LAND SURVEYOR NO. 6a of . STATE OF..FLORIDA. (VALID COPIES OF IS SURVEY WILL BEAR THE EMBOSSED SEAL OF THE ATTESTING LAND SURVEYOR). WOOD FENCE. N " • • CHAIN LINK FENCE. • 0.00 X • • • • C.B.S• WAVL (C.B.W.) EXISTINO g`F,VATIONS. • • • • • • • • PROPOSED ELEVATION • •' REVISED ON REVISED ON • • 1 MIAMI SHORES VILLAGE BUILDING DEPARTM 305- 795 -2204 Building Inspection Reques Date )b'tb' b3 Time R ' 20 Type Insp'n Permit No. t D 3 ^ 10 Name Address t d Co S 9( Z Company Phone # SOS For Inspector: CL 10 1 1 4b3 Name & Date Approved LY Correction ❑ Re- Insp'n Fee ❑ e5-5