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EL-04-84PERMIT APPLICATION FOR MIAMI SHORES VILL4. (W 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138 • Phone: 305-795-2204• Fax, 305-756-8972 _ WJrn `" `! ` 2004 Date Job Address ��� �. %�� _% Tax Folio Legal Description / Historically Designated: Yes�l.�� No .� Owner/Lessee/Tenet 45 s' -lo", Master Permit # Owner's Address �® p ��� 577 Phone i Contracting Co. ��G� ! e_ Address ! ��� ��Q 51 Qualifier 6�e 77— ;Wle ° 51e SS# ���dd - 3��%3 Phone �� / �Ue373 State # Za13eD/F7__S' Municipal # Competency # Ins. Co, IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE -INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING WORK DESCRIPTION: WM Square Ft. Estimated Cost (value) s N WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ANY ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for all disciplines. 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. Furthermore, I authorize the above named contractor to do the work stated. Signature of owner and/or Condo President Date n,� � - Notary as tJ Owner and/or Condo President Date Signature of Contractor or Owner Builder Da 500 4 -10 rajKY" . My Commission Expires My Co YO lc� FEES: PERMIT RADON APPROVED: 2-C) Zoning Building 0 Mabel Vargas an mis&n #DD23191 as to Contractoro/OVgq I Date ,w . , .• � BondedThru mmission Expire '�i@„ ,�° _ Atlantic Bonding Co., Inc. C.C.F NOTARY BOND TOTAL DUE Electric ������� cif/ Mechanical Plumbing. Structural Engineer ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM UNIT FEE SPACE HEATERS BIDET LIGHT OUTLETS CENTRAL HEATING 01SHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHAFE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POW COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS tJRINAL MOTORS OVER 25-100 HP COOLING TOWERS 'RATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER -REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMIERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS ORAINFIELD, 4' TILE/RES. VIOLATION ?UMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. 'ATCH BASIN ]ISCHARGE WELL MMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER =IRE STANDPIPE UL PIPING .AWN SPRINKLER SYSTEM 14 RANGE 4ETER SET (GAS) 1AS PIPING TITLE COMPANY OF AMERICA, INC. ESCROW ACCOUNT FILE #: A0816776 AMOUNT: $75.00 PAYEE: -- MIAMI SHORES VILLAGE HALL PERMIT NO. EL04-84 SELLER(S) -- BUYER(S) -- SUE S. EDMISTON PROPERTY LOCATION -;- 790 NE 95TH STREETjMIAMI, FLORIDA 33138 PERMIT FEE DATE: 12/05/08 CODE: CK #: 2014 ALT: UP mrN`01 DETACH AND RETAIN THIS STATEMENT 002014 TCAW�k rifle Cmpminy ofAmeriia 5835 Blue Lagoon Drive Suite 200 Miami, FI 33126 Tel. (305) 461-5995 Fax. (305) 461-9881 DECEMBER 5, 2008 MIAMI SHORES VILLAGE HALL 10050 N.E. 2ND AVENUE MIAMI SHORES, FLORIDA 33138 Re, SUE S. EDMISTON REFINANCE Our File #: A0816776 Property Address: 790 N.E. 95TH STREET MIAMI, FLORIDA 33138 PERMIT NO. EL04-84 Dear Sir or Madam: With regards to the above referenced file, enclosed please find the following: a) Check number 002014 in the amount of $75.00; representing the payment for the open Permit Fee. b) Settlement Statement. Should you have any further questions, please feel free to contact me. Sincerely, �� 0 Rosa A.Pazos Post Closing Department "L inT I�In" % UU1/UU1 cr 11 -- L,i®ra Sparc P,L 33138 Miami Stiorest V111+dB® He� Miami Shor®aa, $. 2ad AVe,zau® — 306—'7fifi-89?2 1006FOho a 306—?96-220?/gax **FOR FASTER PROCESSING, PLEASE MAKE SURE THE ATTENTION LINE ON YOUR ADDRESS LABELS, LETTERS AND ENVELOPES TO US FOR LIEN SEARCHES READS: "ATTN: CLARA BENDER"** - ALSO, SELF ADDRESSED AND STAMPED ENVELOPES ARE NOT REQUIRED. ALL INFORMATION IS RETURNED VIA FAX *Please advise the closing agent of the following: All payoffs must be accompanied with a copy of the settlement statement and this lien disclosure ,and must be sent in an envelope marked to the attention of Clara Bender for proper credit, and in order to update our property records for all properties sold or refinanced. Our address and fax number is noted above. As of today's date, 11-12-08, the above property is paid in full $187.63 for garbage and stormwater fees for the service period of 10-01-08 through 12-31-08 with no balance due at this time. - This information is subject to change. Therefore, it is very important to call and get a status update on this information prior to closing Must submit a new lien search fee if any updates are needed after 12-12-08. (For further information or updates in this section, please call Clara Bender at 305-7624857/email Bendercamiamisborgvilla c corn) CODE ENFORC-EMENJ There are currently no Code Enforcement violations on the property. - This information is subject to change. Therefore, it is very important to call and get a status update on this information prior to closing. Must submit a new lien search fee if any updates are needed after 12-12-08. - (For further information or updates in this section, please call Valerie Bierley at 305-795-2207) j 11171I DING - *Please note: If there are any open or expired permits listed in this section, please be advised that all open and expired permits must receive final inspection in order to be closed out.` As of today's date, there is an expired A/C -electric al permit #EL04-84 with a balance due of $75.00. To date, there has not been a certificate of reoccupancy application which is required by the Village's Code prior to the sale of the property. If the above described property is a vacant lot, condominium or a townhouse, a reoccupancy certificate is not needed. - This information is subject to change. Therefore, it is very important to call and get a status update on this information prior to closing. Must submit a new lien search fee if any updates are needed after 12-12-08. (For further information or updates in this section, please call Claudia Cubilios at 305-5-220) -- Prepared By ? 1 Clara Be der - mance Dept. -Date ' A. Settlement Statement - U.S. Department of Housing and Urban Development eir OMB Approval No. 2502-0265 (expires 11/30/2009) B. Type of Loan 1.0 FHA 2.0 RHS 4.0 VA 5.0 Conv. Ins. 3.0 Conv. Unins. 6. File Number A0816776 7. Loan Number 1879290 8. Mortgage Insurance Case Number C. Note: This form is fumis marked •(p.o.c.)• i ied to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are vere paid outside the dosing: they are shown here for information purposes and are not included in the tools. 4hown. Items D. Name and Address of Borrower SUE S. EDMISTON 790 NE 95TH STREET MIAMI, FLORIDA 33138 E. Name and Address of Seller F. Name and Address of MORTGAGE AMERICA 3211 PONCE DE LEO CORAL GABLES, FLO ender ASSOCIATES, INC. BLVD #204 IDA 33134 G. Property Location 790 NE 95TH STREET MIAMI, FLORIDA 33138 H. Settlement Agent TITLE COMPANY OF AMERICA, INC. Place of Settlement 8550 N.W. 33RD STREET #200 MIAMI, FLORIDA 33122 I. Settlement Date 12/01/08 DD: 12'10510.8.7- J. SUMMARY OF BO RROWERS TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DIJ E FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER 101. Contract sales price 401. Contract sales price 102. Personal property 402. Personal property 1b3. Settlement charges to borrower Oine 1400 6,298.26 403. 104. PAY-OFF: WACHOV 46,995.04 404. 105. PAY-OFF: FIRST HOF IZON 136,272.22 405. Adjustments for Kerr, s paid by seller in advance Adjustments for Items paid by seller in advance 106. Ci /town taxes to 406. C4~ taxes to 107. County taxes to y taxes to 407.Count 108. Assessments to 408. Assessments to 109. 409. 110. 410. i 11. PERMIT FEE 75.00 411. 112. 412. 120. GROSS AMOUNT D E FROM BORROWER 189,640.52 420. GROSS AMOUNT DUE TO SELLER 200. AMOUNTS PAID BY R IN BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT TO SELLER 201. Deposit or earnest m ey 501. Excess Deposit (see Instructions) 202. Principal amount of n w loan(s) 190,000.00 502. Settlement charges to seller (line 1400) 203. Existing loan(s) taken ubject to 503. Existing loan(s) taken subject to 204. 504. Payoff of first mortgage loan 205. 505. Payoff of second mortgage loan 206. 506. 207. 507. 208. 508. 209. 509. Adjustments for Iterr s unpaid by seller Adjustments for Items unpaid by seller 210. Ci~ taxes to 510. CI /town 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 BY / F R BORROWER 190 000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 300. CASH AT SETTLEM NT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER 301. Gross amount due fron borrower line 120 189,640.52 601. Gross amount due to seller line 420 • 302. Less amounts paid b ffor borrower line 220 190,000.00 602. Less reduction amount due to seller line 520 303. CASH TO BORROWER 359.48 603. CASH TO SELLER 11-26-2008 at 4:17 PM I form HUD -1 (3/8Q) ref Handbook 4305.2 U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT PAGE 2 700. L.'S&TTLEMENT C GES: File Number. A0816776 TOTAL SALESBR KEWS COMMISSION based on price $ PAID FROM BORROVIEWS FUNDS AT SETTLEMENT PAID FROM SELLER'S FUNDS AT SETTLEMENT Division of commtss n line 700 as follows: 701. $ 702. $ 703. Commission paid at etBement 704. 800. ITEMS PAYABLE Ib CONNECTION WITH LOAN P.O.C. 801. Loan Ori nation F % MORTGAGE AMERICA ASSOCIATES 475.00. 802. Loan Discount % 803. Appraisal Fee to FLORIDA APPRAISAL SERVICES 300.008 804. Credit Report to MORTGAGE AMERICA ASSOCIATES 55.00 805. Lender's Ins ecUon --ee to 806. Mtg. Ins. Applicaflon Fee to 807. Assum tlon Fee to 808. FLOOD CERT FEE MORTGAGE AMERICA ASSOCIATES. 18.00 809. ADMINSTRATION FEE AMTRUST BANK 260.00 810. LOAN SET UP FEE AMTRUST BANK 455.00 811. YIELD SPREAD PREMIUM PD TO MORTGAGE AMERICA BY AMTRUST BANK 4028L 812. DOCUMENT PREPARATION FEE MORTGAGE AMERICA ASSOCIATES 285.00 813. PROCESSING FEE MORTGAGE AMERICA ASSOCIATES 325.00 814. WIRE FEE MORTGAGE AMERICA ASSOCIATES 25.00 815. COURIER/FAX/EMAIL FEE MORTGAGE AMERICA ASSOCIATES 55.00 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest from 12/05/08 to 12/01/08 $ -31.88 /day 4 day(s)- 127.52 902. Mortgage Insurance Premium to 903. Hazard Insurance Premium yrs. to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance 5 mo. $ 45.58 / mo. 227.90 1002. Mortgage Insurance mo. $ / mo. 1003. City propertytaxes mo. $ / mo. 1004. County property 3 mo. ON 118.18 / mo. 364.64 1005. Annual Assessmen mo. $ / mo. 1006. FLOOD INSURANC 5 mo. $ 125.00 / mo. 625.00 1007. mo. ON / mo. 1008. Aggregate Credft for Hazard/Flood Ins, City/County City/CountyProp Taxes Mortgage Ins & Annual Assessments 1.16 1100. TITLE CHARGES 1101. Settlement or clostn g fee to TITLE COMPANY OF AMERICA 290.00 1102. Abstract or tltle seat ch to ATTORNEYS TITLE INSURANCE FUNDITCOA 195.00 1103. Title examination to 1104. Title insurance bind r to 1105. Document prepared n to ANIBAL DUARTE-VI ESQ. 300.00 1106. Notary fees to 1107. Attorney's fees to includes above tte No: 1108. Title insurance to ATTORNEYS TITLE INSURANCE FUND 1,025.00 1109. 1110. includes above Ite No: Lender's covers a 190,000.00 ---1 025.00 Owner's coverage 1111. Form 9, ALTA 8.1 ATTORNEYS TITLE INSURANCE FUND 127.50 1112. RECERTIFICATION OF TITLE ATTORNEYS TITLE INSURANCE FUND 195.00 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording fees Deed $ ; Mortgage 114.00 ; Releases $ 20.00 134.00 1202. City/county/stamps Deed $ ; Mortgage $ 1203. State tax/stamps Deed $ ; Mortgage $ 665.00 665.00 1204. Intangible Tax Deed $ ; Mortgage $ 380.00 380.00 1205. RECORD AFFIDA 10.00 1300. ADDITIONAL SEn LEMENT CHARGES 1301. Survey to 1302. Pest ins ecUon to 1303. COURIER FEE TITLE COMPANY OF AMERICA 150.00 1304. WIRE TRANSFER F EE TITLE COMPANY OF AMERICA 25.00 1305. LIENLETTERS ONE STEP LIEN SEARCHES 120.00 1306. LIEN LETTERS 1307. POST SELLERS DCCS 1308. 1400. TOTAL SETTLEMEINT CHARGES enter on Imes 103 and 502 Sections J and 6,298.26 I have ceretu awed the HUD -1 � Settlement Statement and to the best of my knowledge and belief, it Is a true and accurate statement of all receipts and disbursements transectii c thal�a a received a copy of the HUD -1 Settlement Statement. SUE S. EDMISTON a ------ The The HUD -1 Settlement Statement Which I have I have caused or wAl cause the tamp 1% on my account or by me in this this statement. TiTLE COMPANY OF AMERICA. INC. I Date WARNING: It Is a crime to knovAnglk make false statements to the United States on this or any other sirrdier form. Penalties upon conviction can include a fine or imprisonment For details see: Title 18 U.S. Code Section 1001 and Section 10 11-26-2008 at 4:17 PM form HUD -1 (3/80) ref Handbook 4305.2 Miami Shores Village 10050 NE 2nd Avenue Phone: 305-795-2204 Printed: 3/26/2004 Applicant: SUE Owner: EDMISTON JOB ADDRESS: 790 NE 95 Contractor P & M ELECTRIC INC Local Phone: 305-949-6373 Parcel # 1132060141860 Electrical Permit Permit Number: EL2004-84 EDMISTON SUE ST Contractor's Address: 1936 NE 148 ST Legal Description: MIAMI SHORES SEC 3 PB 10-37 LOT 1 Page 1 of 1 BLK 67 LOT SIZE 70.000 X 129 Fees: Description Amount FEE2004-3204 Building Fee $100.00 Total Fees: $108.30 FEE2004-3205 CCF $0.600 Total Receipts: � FEE2004-3206 Notary Fee $5.00 C FEE2004-3207 Training and Education Fee $0.20 a, 3 FEE2004-3208 Technology Fee $2.50 '1 Total Fees: $108.30 Permit Status: APPROVED Permit Expiration: 9/15/2004 Construction Value: $850.00 Work: INSTALLATION OF WIRING FOR NEW A/C Signed: (INSPECTOR) IA,A% 3 0 PAID 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 responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: