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DS-15-1952 r Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-240537 Permit Number: DS-8-15-1952 Scheduled Inspection Date: October 22, 2015 Permit Type: Driveways/Sidewalks/Slabs Inspector: Rodriguez,Jorge Inspection Type: Final Owner: RINEHARD, KEITH K Work Classification: Addition/Alteration Job Address:836 NE 100 Street Miami Shores, FL 33138- Phone Number (305)968-0517 Parcel Number 1132060340040 Project: <NONE> Contractor: IBERICA CONTRACTORS USA CORP Phone: (786)200-0423 Building Department Comments CONCRETE SLABS DRIVEWAY AND SIDE WALK Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed &�6v ti Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is aid. P p October 21,2015 For Inspections please call: (305)762-4949 Page 7 of 55 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-240537 Permit Number: DS-8-15-1952 Scheduled Inspection Date: October 22, 2015 Permit Type: Driveways/Sidewalks/Slabs Inspector: Rodriguez,Jorge Inspection Type: Final Owner: RINEHARD, KEITH K Work Classification: Addition/Alteration Job Address:836 NE 100 Street Miami Shores, FL 33138- Phone Number (305)968-0517 Parcel Number 1132060340040 Project: <NONE> Contractor: IBERICA CONTRACTORS USA CORP Phone: (786)200-0423 Building Department Comments CONCRETE SLABS DRIVEWAY AND SIDE WALK IINNSPECSPEC Passed Comments TOR COMMENTS False Inspector Comments Passed E:1 Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. October 21,2015 For Inspections please call: (305)762-4949 Page 7 of 55 a A j ■t 52 Miami Shores Village 10050 N.E.2nd Avenue NE \Y s ,A Miami Shores,FL 33138-0000 Phone: (305)795-2204 ' pN6, >>-a Expiration: 03/30/2016 Project Address Parcel Number Applicant 836 NE 100 Street 1132060340040 KEITH K RINEHARD Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell KEITH K RINEHARD 836 NE 100 Street (305)968-0517 MIAMI SHORES FL 33138- 836 NE 100 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 7,000.00 IBERICA CONTRACTORS USA CORP (786)200-0423 Total S Feet: 1200 __._.. Q Approved: In Review Available Inspections: Comments: Inspection Type: Date Approved: : In Review Foundation Date Denied: Final Type of Work:CONCRETE SLABS DRIVEWAY AND SIDE Additional Info: Review Planning Bond Return: Classification:Residential Review Building Scanning:3 Review Building Review Building Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Contractors Bond $500.00 Invoice# DS-8-15-56574 CCF $4.20 08/17/2015 Credit Card $624.70 $50.00 DBPR Fee $2.25 DCA Fee $2.25 08/03/2015 Credit Card $50.00 $0.00 Education Surcharge $1.40 Bond#:2807 Permit Fee $150.00 Invoice# DS-9-15-57063 Revision Fee $35.00 10/09/2015 Credit Card $44.00 $0.00 Scanning Fee $9.00 Scanning Fee $9.00 Bond#:2807 Technology Fee $5.60 Total: $718.70 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFI AVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction a zoning. Futhermore, I authorize the above-named contractor to do the work stated. �. October 09, 2015 Authorized Sig atu : w Applicant / Contractor / Agent Date Building Department Copy October 09,2015 1 Miami Shores Village I�Fcv��r�rFU )c\� Building Department SEP 04 2015 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 B -- INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 ' BUILDING Master Permit No.ps PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION RENEWAL LUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: �% ^ O City: Miami Shores County: ti& Miami Dade zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): 6gj�er'�C"_' i ,hC►^p Phone i) Address: 'v&- 620, `if y City: 1'urxccu —1`AL1 7 State: FL Zip: 3Z 11 U Tenant/Lessee Name: Phone#: Email: / [ - CONTRACTOR:Company Name: xL�La6 (.( I �f7J�d V c tNh Phone#: Address: S-L( A,_6_ `06' •( _ City: �Gc.LVL '&4-06 -� State: tL Zip: 3313 Qualifier Name: „hLi_j2_/ PPZ Phone#: Yj?h 9,Y-0 7` State Certification or Registration#:CGL 1SZZ 6 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 2,4000 Square/Linear Footage of Work: '1W =Szy Type of Work: ❑ Additionl /❑ Alteration 11 EI New ,, ,,/) ❑ Repair/Replace El Demolition Description of Work: �� I4 ajGc 'C.Fi_f VV(c CV_ OAA O .S/00-PS Specify color of color thru tile: vt Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ t I TOTAL FEE NOW DUE$ (Revised02/24/2014) Bonding Company's Name(if applicable) Bonding Company's Address _ City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the approvedinspectionwill and a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRA OR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this dayof20 , by day of , 20J by CIWS 1QS ` Com' who is personally known to �Ple who is personally known to me or who has produced T- L L as me or who has produced /—� as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUB Sign: Lc-k - _.-�` S Print: -{N�� -� r� Y \f �u�� Print: Seal: Seal: Notary Public State of Florida EVELYN ARTOLA �° Joanna M Feliciano Notary Public,State of Florida y�c My Commission FF 082753 Commission#EE 167448 iia,*off Expires 01112/2018 ****s*******r ** * ** filly i►tR i- ss* *********** * * APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) �y�aO1s y� Miami Shores Village 10050 N.E.2nd Avenue NES Miami Shores,FL 33138-0000 ti Phone: (305)795-2204 ' 1 Expiration: 03!3012016 Project Address Parcel Number Applicant 836 N E 100 Street 1132060340040 KEITH K RINEHARD Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell KEITH K RINEHARD 836 NE 100 Street (305)968-0517 MIAMI SHORES FL 33138- 836 NE 100 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 7,000.00 IBERICA CONTRACTORS USA CORP (786)200-0423 Total Sq Feet: 1200 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved: : In Review Foundation Date Denied: Final Type of Work:CONCRETE SLABS DRIVEWAY AND SIDE Additional Info: Review Planning Bond Return: Classification:Residential Review Building Scanning:3 Review Building Review Building Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Contractors Bond $500.00 Invoice# DS-8-15-56574 CCF $4.20 DBPR Fee $2.25 08/17/2015 Credit Card $624.70 $50.00 DCA Fee $2.25 08/03/2015 Credit Card $50.00 $0.00 Education Surcharge $1.40 Bond#:2807 Permit Fee $150.00 Invoice# DS-9-15-57063 Revision Fee $35.00 10/09/2015 Credit Card $44.00 $0.00 Scanning Fee $9.00 Scanning Fee $9.00 Bond#:2807 Technology Fee $5.60 Total: $718.70 NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the County Copy public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS,STATE AGENCIES,OR FEDERAL AGENCIES. October 09, 2015 3 40 �s° S Lei Miami Shores Village 10050 N.E.2nd Avenue NE "" Miami Shores,FL 33138-0000 Phone: (305)795-2204 `` E, = fiXORtDA 3 Expiration: 03/30/2016 Project Address Parcel Number Applicant 836 NE 100 Street 1132060340040 KEITH K RINEHARD Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell KEITH K RINEHARD 836 NE 100 Street (305)968-0517 MIAMI SHORES FL 33138- 836 N E 100 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: =7,000.00IBERICA CONTRACTORS USA CORP (786)200-0423Total Sq Fee Approved: In Review Available Inspections: Comments: Inspection Type: Date Approved: : In Review Foundation Date Denied: Final Type of Work:CONCRETE SLABS DRIVEWAY AND SIDE Additional Info: Review Planning Bond Return: Classification:Residential Review Building Scanning:3 Review Building Review Building Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Contractors Bond $500.00 Invoice# DS-8-15-56574 CCF $4.20 DBPR Fee $2.25 08/17/2015 Credit Card $624.70 $50.00 DCA Fee $2.25 08/03/2015 Credit Card $50.00 $0.00 Education Surcharge $1.40 Bond#:2807 Permit Fee $150.00 Invoice# DS-9-15-57063 Revision Fee $35.00 10/09/2015 Credit Card $44.00 $0.00 Scanning Fee $9.00 Scanning Fee $9.00 Bond#:2807 Technology Fee $5.60 Total: $718.70 NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the Finance Copy public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS,STATE AGENCIES,OR FEDERAL AGENCIES. October 09,2015 4 3 o e$°mss i Miami Shores Village ' 'f 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 Phone: (305)795-2204 ,3. E 33 Expiration: 03/30/2016 Project Address Parcel Number Applicant 836 NE 100 Street 1132060340040 KEITH K RINEHARD Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell KEITH K RINEHARD 836 NE 100 Street (305)968-0517 MIAMI SHORES FL 33138- 836 NE 100 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 7,000.00 IBERICA CONTRACTORS USA CORP (786)200-0423 Total Sq Feet: 1200 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Foundation Date Denied: Final Type of Work:CONCRETE SLABS DRIVEWAY AND SIDE Additional Info: Review Planning Bond Return: Classification:Residential Review Building Scanning:3 Review Building Review Building Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Contractors Bond $500.00 Invoice# DS-8-15-56574 CCF $4.20 DBPR Fee $2.25 08/17/2015 Credit Card $624.70 $50.00 DCA Fee $2.25 08/03/2015 Credit Card $50.00 $0.00 Education Surcharge $1.40 Bond#:2807 Permit Fee $150.00 Invoice# DS-9-15-57063 Revision Fee $35.00 10/09/2015 Credit Card $44.00 $0.00 Scanning Fee $9.00 Scanning Fee $9.00 Bond#:2807 Technology Fee $5.60 Total: $718.70 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-named contractor to do the work stated. October 09, 2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date iBuilding De arment Copy October 09, 2015 1 RIZVIsAm"" ION OCT 0 2 2015 - rt tv^,rami Shcres Village APPROVED BY DATE x 44 7CP.IING DEPT B!_.DG DEPT ' �- STf7f>S : 3vx SUBJECT fO CCNIPLIANCE WUH ALL.FEDERAL C{(" l2 NATE AN C��UN i f aULLS AND REGULATIONS � _.._ _. _ _._,. 46 x IG3 a� O LN sta3 :00 • • . . . 2 e� 1 Q ••• ..• ..• , �V Cz /v" • • • • s•V�ry,�a[(�•.• -jam oo _7L tww • • ' SEP 0 4' 2015 BY: k r _ M AV xin AW clew MQaSur� �0" x �g 1 aa•/ TOAI Op I � W � NEW Ti LFfl ej cn, Lu .. .. . . . .. u l -S 12" . . . . . . . . . . g3� nC7 loo sr� ... . . . ... . . - N. E. lUUTH 61NEET. `(100' RIGHT—OF—WAY)- .7.- + .,..'o�.`, : ,. " .." ..:',:1010' �:•.• •. - �- +. i• M ASPHALT PAVEMENT.' I oo: ,a. ► 1., I ..: .....• : -:10:10.•" ... • .. .I .11.7' ASPHALT PARKWAY• r r to I _ I + •I /77 t COBLOCK RNER ; •�: :�•':• .:t;`r•�.:4 :5.3' CONC WA LK�• • I FOUND 1/2' 1 I IRON ROD I i0 227.30' 75.00'(C) •• 25.00'(P) 90• 00'(P) S0.00'(P) FOUND 1/2' • i •• • •• o,� IRON PIPE ••••• • • •j FOUND 1/2-1 o/s 0.07'(S) • ' f • IRON PIPE �+ •••••• ASPHALT 0.10'(W) •••••� • • • • io DRIVE j WALK NC `O to • • • • c • f ••••••j N . " ~'1010 " • •� •••• •• •� PLANTER • •••f 1010••• (TYP.) 1010•• 1010•• ' '10.4:"�. • • • 10.20'— j 3.75' • 1010•• ••••1 •13.43' 117.33' •o •• 9.84' •••1060 1010•• 1010••• A/C °D • • • ...... �.:. NuJ T1�F •••• j 8.8' /24.27 L. /AAJb�s b C. Lq COVERED 0 ENTRY 1 STORY C.B.S. .� RESIDENCE #836 v � jC6 10.3 9.13' j / .87"* 9.41' m j •.gONC, •: '+• � WEST 1/2 j \ Ln A. LOT 7 I— BLOCK 169 co '•corcok O (NOT INCLUDED) y1 ,2O.O5v'// \ EAST 1/2 LOT 7 BLOCK 169 o I OVERHEAD j j LOT 6 "VAR S < > 1.7' j FOUND 1/2- , BLOCK 169 -to IRON PIPE o/s 0.08'(S) "� 0�, Sc9- " FOUND ON PIPE 0.79'(E) °j 'so o/s 0.31'(W) :,.'POWER, 9.3' ASPHALT PAVEMENT (15' ALLEY ^r }f{ 14 mp s*!°aEs i Miami Shores Village tvow 10050 N.E.2nd Avenue NE CSG �T )WditiglAltr` n; Miami Shores,FL 33138-0000JJ 5 `rywre � Phone: (305)795-2204 e rExpiration: 02/13/2016 Project Address Parcel Number Applicant 836 N E 100 Street 1132060340040� � KEITH K RINEHARD Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell KEITH K RINEHARD 836 NE 100 Street (305)968-0517 MIAMI SHORES FL 33138- 836 NE 100 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 7,000.00 IBERICA CONTRACTORS USA CORP (786)200-0423 Total Sq Feet: 1200 Approved: In Review Available Inspections: Comments: Inspection Type: Date Approved: :In Review Final Date Denied: Foundation Type of Work:CONCRETE SLABS DRIVEWAY AND SIDE Additional Info: Review Planning Bond Return: Classification:Residential Review Building Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Contractors Bond $500.00 Invoice# DS-8-15-56574 CCF $4.20 DBPR Fee $2.25 08/17/2015 Credit Card $624.70 $50.00 DCA Fee $2.25 08/03/2015 Credit Card $50.00 $0.00 Education Surcharge $1.40 Bond#:2807 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $5.60 Total: $674.70 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-na ed c tractor to do the work stated. August 17, 2015 Authorized Signature:Owner / Applica ontrac or V / Agent Date Building Department Copy August 17,2015 1 sEp 1 g 2015 IBERICA CONTRACTORS USA Corp. 54ne 106st Miami Shores,FI 33138 .... ...... Permit number: DS-8-15-1952 •••�•• Keith K Rinehard ••••' 836 ne 100 st Miami Shores 33138 ' k � � ' • The customer only wants to change the tiles. He does not want to make any modification in the size of the steps. _j �b vv� 1 Miami Shores Village F CEW ." J i Building Department AUG 032015 � 1 g p 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 BY- INSPECTION LINE PHONE NUMBER:(305)762-4949 � FBC 201zl BUILDING Master Permit No'f s /S /9�`2 . PERMIT APPLICATION Sub Permit No. XBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP � ,; l CONTRACTOR DRAWINGS JOB ADDRESS:_��l•^ /y /c% 1 j��t' ? City: Miami Shores County: Miami Dade Zip: 3 3/J d~r Folio/Parcel#: Is the Building Historically Designated:Yes. NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): ;r'' +r �, Phone#:S6' Address:_ Y & Ali- 100 �t City: "Aill%; 90-14, State: rL Zip: Tenant/Lessee Name: Phone#: Email: 0A, V1 Yv+IG: t. CONTRACTOR: Company Name:_2'E?-,6.4 &w-i M r-7WZS' (JSA4 rU,el; Phone#:k a)�>) 9kI t,9 L2 Address: 106 -'' ~ City: �'l/�6 btf --lt`�O/Z�"S State: C v2t'! —Zip: � �c� Qualifier Name: Jo yJi r 1_'E?7e-Z &�b1��) Phone#: 1 , V �S U State Certification or Registration#: CC-C f12-2-623 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ L. Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration El New ❑ Repair/Replace ❑ Demolition Description of Work: ruucl1. l J CUTQd�/% �'iC&L'Lft: )j< O-zi Specify color of color thru tile: Submittal Fee$ �r Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ — DBPR$ Notary Technology Fee$ Training/Education Fee$ _Double Fee$ Structural Reviews$ Bond$! Oc)• '� TOTAL FEE NOW DUE$6l (Revised02/24/2014) • Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will ap ed and a reinspection fee will be charged. d Signature 4. Signature 4, 2- 1 t O or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of � 20 1� by -31 day of20 l S by �� t`4ttP who is personally known to �`2-- �� 2--who is personally known to me or who has produced C-, 0-2— as me or who has produced � ��'"r`�Z as identification and who did take an oath. identification and who did take an Qat . NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: Seal: EVELYNARTOLA Seal: Notary Public,State of Florida Commission#EE 167448 t] My comm.expires Feb.7,2016 APPROVED BY �IJ I Plans Examiner Y �Jr Zoning Structural Review Clerk (Revised02/24/2014) HUD-1 OMB Approval No. 2502-0265 A. Settlement Statement (HUD-1) B. Type of Loan 1,FNA 2. RHS 1 Genv,Unins. 6.File Number 7.Loan Number 8. Mortg.Ins.Case Num. 4.V.A. 5.Conv. Ins. 15-Rinehar-3709 252386233 ID: C. NOTE.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"(p.o.c.)"were paid outside the closing;they are shown here for informational purposes and are not included in the totals. D.NAME OF BURROWER: Charles D.Perez and Keith K.Rinehard,husband and husband Address of Borrower: 836 NE 100 Street,Miami Shores, Florida 33138, E. NAME OF SELLER: Debra D.Cavanaugh as Personal Representative(s)of the Estate of Evelyn F.Massie,deceased Address of Seiler: 1550 Argyle Drive,Fort Lauderdale, Florida 33312 R NAME OF LENDER: Bank of America,N.A. Address of Lender: c/o PHH Mortgage, 1 Mortgage Way, Mount Laurel,New Jersey 08054 G.PROPERTY LOCATION! 836 NE 100 Street,Miami Shores, Florida 33138 H.SETTLEMENT AGENT: Kien&Lowman,LLP Address: 8620 NE 2 Avenue,Miami,Florida 33138 Phone:305-981.4477 Place of Settlement: 8620 NE 2 Avenue,Miami,Florida 33138 L SETTLEMENT DATE: 7120/15 DISBURSEMENT DATE: 7/20115 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 535,000.00 401.Contract sales price 535,000.00 102, Personal property 402.Personal property 103,Settlement charges to borrower(Line 1400) 25,128.601 401 104. 404,, 105. 405. ....Adjustments far Items old b VV sel er la advance: Ad ustments for 1+ams pall toy setter Irr advance: 106.City/town taxes 406.City/town taxes 107.County tastes 4137.County taxes 108.Assessments 408.Assessments 109. Pre-Occupancy Rent from 07108115 to 07120/15 1,354.80 409.Pre-Occupancy Rent from 037/08/15 to 07120/15 1,354.80 110. 410, 111. 411. 112, 412. 120.Gross amount due from borrower: 561,483,40 420.Gross amount due to seller: 536,354.80 200 Amounts paid or In behalf of borrower: 500.Reductions in amount due to salter: X201. Depositor earnest money i 50,000.00 501. Excess deposit(see Instructions) 202.Principal amount of new loan(s) 315,000.00 5012.Settlement charges to seller(line 1400) � 34,941,50 203.Existing loan(s)taken subject to 503.-Existing loan(s)taken subject to '1204,Principal amount of second mortgage 504.Payoff of first mortgage loan(ATONE) 1205. 505. Payoff of second mortgage loan 206. 506, 207, 507.Deposit is being disbursed as proceeds 208.Principal amt of mortgage held by seller 508.Principal amt of mortgage held by seller 209. 509. 209x. 509x. -Aclustments-# r items un ald'b seller: 210.City/town taxes 510.City/town taxes 211.County taxes from.01101115 to 07120/15 1,668.50 511.County taxes from 01101115 to 07/20115 1,668.50 212,Assessments 512.Assessments 213, 513. 214. 514. 215.Seller Paid Doc Stamps 3,210.00 515.Seller Paid Doc Stamps 3,210.00 216, 596. 217. 517. 218, 1518, 219. 1519, 220.Total paid by/for borrower: 369,878.50 520.Total reductions in amount due seller: 39,820.00 30€3.Cash at settlement fromito borrower: 800.Cash at;Rtlement tolfrom seller: 301.Gross amount due from borrower (line 120) 561,483.40 601.Gross amount due to seller (line 420) 536,354.80 HUD-1 U.S.Department of Housing and Urban Development rage 2 .Settlement charges 700.Total Real Estate Broker Fees $32,100.00 Paid from Paid from Division of commission Iine 7001 as follows: Borrower's seller's Funds at Funds at 701. $16,050.00 to Keller Williams Eagle Realty Settlement Settlement 702, S 16,050.00 to Keller Williams,Eagle Realty 703. Commission paid at settlement 704. 32,104.44 705,Processing Fees-NTA to Keller Williams Eagle Realty 800, Items Payable in Connection with Loan 801, Our origination charge $4435.00(from GFE#1 802, Your credit or charge(points)for the specific interest rate chosen (from GFE#2) i 803. Your adjusted origination charges to Bank of America,N.A. (from GFE A) 405.00 804. Appraisal fee to Landsafe Appraisal Services, Ii (from GFE#3) 430.00 805. Credit report to Corelogic Credco (from GFE#3) 15.00 806. Tax service to Corelogic Tax Services LLC from GFE#3 79.00 807. Flood certification to Corelogic Flood Services LLC from GFE#3 17,00 808. to 809. to 810. to 811. to 812. to 813, to € uir ojae Eald,i 901, Daily Interest charges from 07120115 to 08101115 24.8104 /day from GFE#10 297.72 902.Mortgage Insurance pLemium for months to horn GFE#3 903. Homeowner's insurance premium 1 years to Stiber Insurancefresm GFE#11 6,201.85 904.Flood insurance premium for years to 905, ears to 10M Re DepDsitW with Landpr 1001. Initial deposit for your escrow account from GFE#9 8,36 3.75 1002. Homeowner's insurance 3 months 5518.83 ermonth $1,550.49 1003. Mortgage Insurance months or month 1004. Property taxes 11 months $807.42er month w$,881.62 1005. Flood insurance months er month 1006. monthsfl per month 1007, months ermonth 1008. months per month 1009. Aggregate accounting adjustment ($2,0767,36) 1100.Title Char es 1101. Title services and lender's title insurance (from GFE#4) 955.78 1102. Settlement or closing fee to Kim&Lowman,LLP $600.00 1103. Owner's title insurance to Old Republic Nat.Title/Kim&Lown (from GFE 95) 2,775.00 OF6-2754.00,41-25 1104. Lender's title Insurance to Old republic Nat.Tile/Kim&Lowman $352,$0 F6-25.00;6-25;8.1-25;F9.3-277.50 1105. Lender's title policy limit$315,000.017 1106. Owner's title policy limit$535,000,070 1107. Agent's portion of the total title insurance premium$2,189.25 to Kim&Lowman,LLP 1108. Underwriter's portion of the total title insurance premium$938.25 to Old Re b#lc National Title Insurance Gout 1109. Abstractor title search to Kim&Lowman,LLP 2007.04 1110. Title Surcharge to 01d Republic National Title in:$3.28 1111. Attorney's Fee to Law Office of,john S, Andrev 1,850.470 1112, to 1113. to 1200,Govornmgntcin ZrApsfer Charoes 1201.Government recording cha es from GFE#7 295,00 1202. peed$27.070 Mort a s $259.00 Re€eases$0,00 $286.04 1203.Transfer taxes (from GFE#8) 4,942.50 1244.CitylCounty taxistamps Deed $0.04 Mortgage(s) $6301.00 1205.State tax(stamps Deed $3,210.00 Mortgage(s) $1,102.50 1206.E-Record to Simpllfile $9.00 1207.Record Affidavits,DC,Probate Docs to Miami-Dade County Recorder 75.50 1208.1=-Record to Simplifile 1320, 13,54 _Additional S I ment Charges r 1301. Rr)nu1rP.d:garvirat that vni E ran rhnn fnr SETTLEMENT CHARGES .AND LOAN TERMS Page 3 Seftlement Charges our origination charge #801 $405.00 $405.00 Your credit or charge(points)for the specific interest rate chosen #802 $.00 $0,00 Your adjusted origination charges #803 $405,00 $405.00 Transfer taxes #1203 $5,017,50' $4,942,50 Government recording charges #1201 $295,00 $295,00 Appraisal fee #804 $430M $430M Credit report __. 805 $15.00 515.00 Tax service #806 $79.00 $75.00 Flood certification 807 $17,00 $17,00 $836.00 $836M or 0.00% Initial deposit for your escrow account #1001 $3,791.25 $8.3.75 Dailyinterest charges from #901 $595.44 $297.72 Homeowner's insurance premium for #903 $6,201.85 $6,201.85 Title services and lender's title insurance #1101 $835,78 $955,78 Owner's title insurance #1103 $2,825.00 $2,775.00 Survey #1304 $600.00 $350.00 Loan Terms Your initial loan amount is $315,000.00 Your loan term is 30.0000 years Your initial interest rate is 2.$75 % Your initial monthly amount owed for principal,interest, $1,306.91 includes and any mortgage insurance Is Principai rVr interest r mortgage insurance Can your interest rate rise? ! No 0 Yes , it can rise to a maximum of 7.875%,The first change will be on 0$11120.22 and can change again every year after 08/1/2022 Every change date,your interest rate can increase or decrease by 2.00 ala.Over the life of the loan,your interest rate Is guaranteed to never be lower than 2.25%or higher than 7,875%. Even if you make payments on time,can your loan No 0 Yes ,it can rise to a maximum of$.00 balance rise? Even if you make payments on time,can your monthly `) No 0 Yes ,the first increase can be on 081112022 and the monthly amount amount owed for principal,interest,and mortgage insurance rise? owed can rise to$ 2,070.93 The maximum it can ever rise to is 52,070,93 Does your loan have a prepayment penalty? ! No r; Yes ,your maximum prepayment penalty Is$.00 Does your loan have b balloon payment? 0 No Yes ,you have a balloon payment of$ ,00 due in years on 00./0010000 Total monthly amount owed Including escrow 0 You do not have a monthly escrow payment for items,such as properly account payments taxes and homeowner's insurance.You must pay these items directly yourself, 0 You have an additional monthly escrow payment of$ 1,324.25 that results in a total initial monthly amount owed of$ 2;631.16 This includes j principal,interest,any mortgage insurance and any items checked below; ({ Property taxes Homeowner's insurance HUD-1 SETTLEMENT S'T'ATEMENT ADDENDUM File Number: 15-Rineher-3709 1 have carefully reviewed 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 made on my account or by me In this transaction. 1 further certify that t have received a copy of the HUD-1 Settlement Statement. F Borrow r( .m Ke R. Ttin aryl,, . } charles D. Perez .. N Seller{s} DebraD. Cavanaugh Persona. Representative Settlement Agent The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction. I have caused or will cause the funds to be disbursed in accordance with this statement. Rim & Lowman. LLP f BY= Date. i f i i i i i 1 i i I } COIACY-Cte- C7,A CAO-t'e G�vi�Qw — Zoo s cov�c,r� �e -►'cue wc�Q (z vial �3 rlm AT�a-L-Snoo s t CDU Cfv t w�� -� -✓ P 2 ,q Woo& 2Y, 6 woo& wa tom, •.... , f . no��- A) r-CL 5-C 40-w4A,ov, Z) • r •••• • U ' 3l • • • 14 X i 5T i X16 4y44 d LT _PL i t16LA)Ay �3� tJ F 100 S t 9yg coNc>zGrt.4z SczIS �>RAtl�w,4y n 06vJ Lvov C 12C-r-C SC A$S SiC wCWA 11 SV464r nese •�' Sade\�r�5 teeac��ayl ave a N. E. 100 H S T EET — — P tre Pa do pave�0pe�y s�a�e 5 ��\�� .� . . '. ' ' ..'r .• �_. ..;. Vgay'' yrs �0,\v :; •;- 1 1. � . " `I \��e ad1°off g park°v�d��Au�� :�' L•' ' '(100' IGHT—OF—WAY) ,' •i ,'f: _ •, o y 19' SPHALT PAVEMENT,' sra\,\ee�ire iii'_ •. ;ti.. o'' . ;.� ,• I:11.7' SPHALT ARKWAlei t h I t BLOCK :: • A t; : A r•': ;*' e L 5.3 CONC WALK 4•:%; CORNER =1'' 'r `•!. i ..• • • • '+.' • I,.' FOUND 1/2" IRON ROD 0 I 227.30' i +' 7 o' C 25.00'(P) so. 00'(P)•:' 50.00'(P) FOUND 1/2" CO IRON PIPE I FOUND 1/2" I o/s 0.07'(S) Aw IRON PIPE 00 ,ASPHALT M 3 CONC 0 0.10'(W) o DRIVE I -.• W LK IR In PLANTER (TYP.) a' oI 3.75'10.20' •13.43 I X17.33' 9.84' A/Ca t2 _ m �L� L 8:8' 1` /24.21"///// o 0) i'. Cd COVERED C '•' '' "� ENTRY 1 STORY C.B.S. Y 7n v RESIDENCE #836 v IfTl _ ,�� •!•, O o m 10.3 'a 9.1 5.87 9.41' n - .. 06 .GONG{ •''• • I WEST 1/2 ~' I C7 z a� LOT 7 I— { I BLOCK 169 I ':coNc'� \ O so ro ,.r! .• J 6 0 c I (NOT INCLUDED) TAAlk 1Y.20.05. � rt~� o I I EAST 1/2 • .. �eZp ILOT 7 I OVERHEAD BLOCKI 169 N I LOT 6 UTILITY v , 1.7 WIRES 2<z FOUND 1/2' BLOCK 169 d o I IRON PIPE r ��o I �� i` FOUND 1/2" 0/8 0.0e (S) '� N PIPE 0.79'(E) 90 `r0 o/sN 0.31(W) `'.. •ti:. �+:• , POWER';- 9.3' ASPHALT PAVEMENT (15' ALLEY R/Vq. •• '' r; POLE P�e 1 1 L Y I E 1 1 1 T 1.•. n Florida Health Miami-Dade County •' "' ' ' �• O.S.T,D.S. & Well Program . .. . . . . ... - . Application No.: .. ... .. . . . .. Date: ..• see 000 Signature . • .•. SCALE: 1" = 20' SKETCH NO.: 15-1140 • ••• DRAWN BY: Q.D.I. SIDE 2 OF 2