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: