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FW-14-2269 i j Miami Shores Village OCT 15 2014 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2010 BUILDING Master Permit No. �� z�-'��� PERMIT APPLICATION Sub Permit No. ❑■ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL F-]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 9220 NE 2nd Avenue 33138 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11-3206-013-3060 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): Michele Contessa Phone#:305-761-5243 Address:9220 NE 2nd Avenue City: Miami Shores State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: rxA_7In ` Phone#: Address: City: State: Zip: Qualifier Name: Phone#: State Certification or Registration M Certificate of Competency#: DESIGNER:Architect eer: Phone#: Addr - City: state: Zip: —� Value of Work for this Permit:$ I Square/Linear Footage of Wor !3 S Type of Work: ❑ Addition ❑ Alteration ` ❑ New ❑■ Repair/Replace ❑ Demolition Description of Work: Wooden fence installation to replace existing chain link fence along the backyard only by the alley way side. Two gates will be built with a trash area (5x8). Dog ear wood, PT#2 will be using following the city's specifications as per indicated on the survey. Specify color of color thru tile: Submittal Fee$ �- , Permit Fee$ ( ��, �� CCF$ _ CO/CC$ t,.�.^li4 Scanning Fee$ Radon Fee$ ° 1 DBPR$ Notary$ 'FD ,CAN Technology Fee$ ) Training/Education Fee$ , a ® Double Fee$ " Structural Reviews$_ Bond$ TOTAL FEE NOW DUE$ 92 Pj2_ - , (Revised02/24/2014) y 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 not a app ed and a reinspection fee will be charged. Signature Signature 0 NER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this ,(� 7 day of ��� 20/V' by day of ,20 , by Ja L�e� eQ�� ho is personally known to who is personally known to me or who has prod ucedQ '7r�Q�7��'�'r�as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Si Sign: Public S4ate Florida Print: rru Notary Print: aQ Joanna Seal. My Commission FF 0$2753 Seal: ox Aga Expires 0111212018 ' APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) yes Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 A �^ `1 OWNER BUILDER DISCLOSURE STATEMENT NAME: rl,lC�r JJ e_ L�,,-TSSA DATE: l� �_ I ADDRESS: S12p 1AE 2�)d &R= 0Q Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida,F.S 489.103(7).And I have read and understood the following disclosure statement,which entitles me to work as my own contractor;I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor.You have applied for a permit under an exception to the law.The exemption allows you,as the owner of your property,to act as your own contractor even though you do not have a license.You must supervise the construction yourself.You may build or improve a one-family or two-family residence.You may also build or improve a commercial building at a cost of$25,000.00 or less(The new form states 75,000).The building must be for your own use and occupancy.It may not be built for sale or lease.If you sell or lease a building you have built yourself within one year after the construction is complete,the law will presume that you built for sale or lease,which is a violation of this exemption.You may not hire an unlicensed person as a contractor.It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances.Any person working on your building who is not licensed must work under your supervision and must be employed by you,which means that you must deduct F.I.C.A and with-holdings tax and provide workers'compensation for that employee,all as prescribed by law.Your construction must comply with all applicable laws,ordinances,buildings codes and zoning regulations. Please read and initial each paragraph. 1. 1 understand that state law requires construction to be done by a licensed contractor and have applied for an owner-builder permit under an exemption from the law.The exemption specifies that I,as the owner of the property listed,may act as my own contractor with certain restrictions even though I do not have a license. Initial-_ 2. 1 understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. p Initial ku 3. 1 understand that,as an owner builder,I am the responsible party of record on a permit.I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name.I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on permits and contracts. Initial 4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilding.I may also build or improve a commercial building if the costs do not exceed$75,000.The building or residence must be for my use or occupancy. It may not be built or substantially improved for sale or lease.If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete,the law will presume that I built or substantially improved it for sale or lease,,which violates the exemption. Initial � 5. 1 understand that,as the owner-builder,I must provide direct,onsite supervision of the construction. Initial KK/ 6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence.It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. Initial t 7. 1 understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner-builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I,as an owner-builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner-builder and am aware of the limits of my insurance coverage for injuries to workers on my property. Initial 8. 1 understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done.Any person working on my building who is not licensed must work under my direct supervision and must be employed by me,which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act(FICA)and must provide workers compensation for the employee.I understand that my failure to follow these may subject to serious financial risk. Initial 9. 1 agree that,as the party legally and financially responsible for this proposed Construction activity,I will abide by all applicable laws and requirement that govern owner-builders as well as employers.I also understand that the Construction must comply with all applicable laws,ordinances,building codes, and zoning regulations. Initial_ 10. 1 understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service,the United States Small Business Administration,and the Florida Department of Revenues.I also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or http://www.myfloridalicense.com/dbpr/pro/cilb/index.html Initial 11. 1 am aware of,and consent to;an owner-builder building permit applied for in my name and understands that I am the party legally and financially responsible for the proposed construction activity at the following address: Initial 12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of the information that I have provided on this disclosure. , i Initial {�J Licensed contractors are regulated by laws designed to protect the public.If you contract with a person who does not have a license,the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court.It is also important for you to understand that,if an unlicensed contractor or employee of an individual or firm is injured while working on your property,you may be held liable for damages.If you obtain an owner-builder permit and wish to hire a licensed contractor,you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage. Before a building permit can be issued,this disclosure statement must be completed and signed by the property owner and returned to the local permitting agency responsible for issuing the permit.A copy of the property owner's driver license,the notarized signature of the property owner,or other type of verification acceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this t��day of 0CTO t��, 20 By/�is� -/f.- rall �, ��, who was personally known to me or who has Produced th ekre License oro_&_ x;-��Z�2� —® as identification. blil OWNER ®gylNq NOWYP-NA Joanna9 ' c.ano N O RY nRy t cmmi��fon FF 082753 `�• w ®A Exy�ires 01!12/"2018 ?T-*.2 )Ov d.(ence-to replace ex. A c in •ink nce tV : The c��' NINESEMENESSIM 7>�1^n2nSions the new : 4x4 5 eve 5 I. (3}Zx y w LOCATION SKETCH across 'brilerj ins► 7I'l2 proper wi' r p; vii 11 !a� bve oh a z o y S& CL a.�V0.r1i?ec� wz as SCALE: NTS SIM W I olri the alLy-W A cte 1"�q eVwood i nsfi'czl leCf � E °? �� `� J The lam' 1'F�' � sfinuC}urf mG'ta..� � � � :_ oe ca bogrd :an board. --'"' covered erft�ret a � _ �, �,,,i () 5' tem Cade. The posts will be ins�c�lied o»a w i�h wood on j ` � .v W w - hole 2'�ep1h )t �o' w�dt� w�fi�i &o lb concrete mix . bor% sides. LOT 2 BLOCK- 23 ' ( R & M ) a"O a a z ' .••t''_�. .. r130.00 vz 0 $ 03 23 3C.$.S WALL W 40.00' �''_ �� 0.10' L O° °O�oO ���-. .'. •• ©'`u '• ? 2 W " 3s0' 36.65' .. , . . e r 4 ,a o •°'' ` '�Q Q ` sJ LJ F N ' • PO H� � PORCH �4 1u..'.B. LLI ;n.:�:'.ca'..4' a -1 9.00' 14' z 12.90' TWO STORY "' ` ..•off F ¢ a I Z ' '• - C.B.S. RESIDENCE ' s; �'� w .. . •'.w.•,otf 5.00 •• '.': 3 ... . f N �:,,� ❑ LOT 3 0 �-rJl #9220 ,.,0 O LU �I BLOCK 23 o O, F.F.ELEV.=11.60 9.10 d '. '.; ':::. ,: ;;; _ > _ : : ,. =� .�.' n .a N gL t 12.85' �^ '� Q'..;•...:,'.::':'•: '•': •': a E a 0 '" 31.30' . ox W. .. Q'•'ti r, 44.15 3;:. • [1 U ' o - - - - - - Ell U O t" i 020 96 ° •C. { c C' E, CJ LLI I '•' �5' 8, LOT 4 "' cS O°00, �.: c ``r . c,,, ? { . _.__.._ d '•' METAL OWN BLOCK 23 n 00„ .'uo':.'.. . ,'.•.'.• •:-•'.••'.••',••'.;•'.9;.. a a .'i £,. •.,• v UTILITY ' �'::: '•'. •'::•'::•'::•'::•:: r,. d p .► FOS 3 -� 6' VF a - `.'. ' .40.00'... [�.""'5, ou 130.00' ( R & M ) f a N^ • _ - �'� E~ REMAINDER o Q : o O LOT 4 r u° Property Address: 9220 N.E. 2nd Ave., Miami Shores, FL. 33138. A c BLOCK 23 r O. O� w z knCertified To: Michele Contessa and Leslie A. Neine;Green and Kahn, P.L.; Old Republic National Title Insurance Company; Flagstar bank, FSB its successors and/or assigns,appearing of record as Mortgage Electronic Registration Systems, Inc. as the insured 5151 Corporate Drive ABBREVIATIONS: Troy, M 148098 SYN(=SIDEWALK,CBS=CONCRETE BLOCK STRUCTURE,CLF=CHAIN LINK FENCE,PL=PROPERTY LINE,DUE=DRAINAGE UTILITY EASEM ENT,IP=IRON FIFE. F=FOUND.AIC=AIR CONDITIONER PAD,PIC=PROPERTY CORNER.D/H=DRILLED HOLE,WIF=V,000ENFENCE,RES=RESIDENCE,CL-CLEAR,RB=REE':AR, Legal Description: Lot 3 and the North 21 feet of Lot 4, Block 23, MIAMI SHORES SECTION ONE - UE=UTILITY EASEMENT. CONC=CONCRETE SLAB, RAPD-RIGHT OF WAY, DE=DRAINAGE EASEMENT, CIL=CENTER LINE, O=DIAMTER, TYP=TYPICAL, AMENDED, according to the Plat thereof,as recorded in Plat Book 10, at Page 70, of the Public Records M=MEASURED.R=RECORDED,ENCR=ENCROACHMENT,COMP=COMPUTER,ASH=ASPHALT,NID=NAIL&DISC,S=SET.FEE=FINISH FLOOR ELEVAT'ON, 015=OFFSETP/P=POWER POLE.OHP=OVERHEADPOWERLINE,WM=NATERMETER of Miami-Dade County, Florida. TMOM1,-MAsoNRY�LL= ELEVATION BASED ON LOC. # 3100 .. •.. CONCRETE= .:.:..:.:•.�. :: •::: •�:. .:.:..:••:. ELV. FALID UNLESS EMBOSSED WITH MAINTENANCESDRAINAGEEASEMENT=M&D.E. CBM# N-568 9•65' TYPE OF SURVEY:BOUNDAW SURVEY • • • SINCE 1987 URVEYOR'S SEAL !HEREBY CERTIFY That the survey represented • ••• • SURVEYOR'S NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2)NOT VALID WITHOUT THE SIGNATURE thereon meets the minimum technical requirements! •• •+ + : .++3LANCO SURVEYORS INC. AND RAISED SEAL OFA FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT adopted by the STATE OF FLORIDA Board of Land - -• = COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. S) Surveyors pursuant to Section 472.027 Florida Engineers•Land Surveyors•Planners•LB#0007059 UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODFi'iC Statutes. • ••• • • • •`• e ••• 555 NORTH SHORE DRIVE VERTICAL DATUM OF 1929.. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITlON.4lL There are no encroachments, overlaps @dements : + • + - RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAYBE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9) appearing on the plat orvisible easements o0hertn "• • + : ; MIAMI BEACH,FL 33141 CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING as shown hereon. • ` •(Op5);$�65-1200 rail:blancosurveyorsinc@yahoo.Com Fax: (305) 86,5-7810 INFORMATION. 10)EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED REVISED: 10/13/14 INSTRUMENTS,IF ANY,AFFECTING THIS PROPERTY z FLOOD ZONE: g SUFFIX: I DATES 11 09 BASE: A Additions or deletions to survey maps or reports by other than the signing party or parties is prohibited �;• • • FOR ELEVATIONS i11znout written consent of tine si p lv07 COMMUitiiT'f# 120652 gnmg party or parties. Au.S N.NUNEZ 70 REGISTERED LAND SURVEYOR;•• l�f �•3 •4 • SCArLE: OWN.BY: JOB No BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE-OF SAID Pb 10 PAGE STATE OF FLORIDA#591'L�l• y d.�.. 1"'x'20' F.Blanco 14-791 r r* fil NTI Thi ,n HUD-1 OMB Approval No. 2502-0265 A. Settlement Statement (HUD-1) B. Type of Loan 0 1. FHA 0 2.RHS 3.Conv. Unins. 6.File Number 7.Loan Number 8. Mortg.Ins.Case Num. 0 4.V.A. 0 5.Conv. Ins. GK-14-0504 504199651 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 BORROWER: Michele Contessa and Leslie A.Neine,husband and wife Address of Borrower: 9220 N.E.2 Ave,Miami Shores, Florida 33138 E.NAME OF SELLER: Edward Roberts,Successor Trustee of the Victor Rivera Revocable Trust dated December 10, 1996 Address of Seller: 317 71st Street,Miami Beach, Florida 33141 F.NAME OF LENDER: FLAGSTAR BANK,FSB Address of Lender: 5151 Corporate Drive,Troy, Michigan 48098 G.PROPERTY LOCATION: 9220 N.E.2 Ave,Miami Shores, Florida 33138 H.SETTLEMENT AGENT: Green and Kahn, P.L. Address: 317 71st Street,Miami Beach,Florida 33141 Phone:305-865-4311 Place of Settlement: 317 71st Street,Miami Beach, Florida 33141 I. SETTLEMENT DATE: 10/6/14 DISBURSEMENT DATE: 10/6/14 i 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 387,000.00 401. Contract sales price 387,000.00 102. Personal property 402. Personal property 103.Settlement charges to borrower(Line 1400) 12,138.51 403. 104. 404. 105. 405. Adjustments for items paid by seller in advance: Adjustments for items paid by seller in advance: 106.City/town taxes 406.City/town taxes 107.County taxes from 10/06/14 to 12/31/14 2,670.72 407.County taxes from 10/06/14 to 12/31/14 2,670.72 108.Assessments 408.Assessments 109. 409. 110. 410. 111. 411. 112. 412. 120.Gross amount due from borrower: 401809.23 420.Gross amount due to seller: 389,670.72 200.Amounts paid or in behalf of borrower: 500.Reductions in amount due to seller: 201. Deposit or earnest money 20,000.00 501. Excess deposit(see instructions) 202. Principal amount of new loan(s) 309,600.00 502.Settlement charges to seller(line 1400) 40,362.14 203. Existing loan(s)taken subject to 503.Existing loan(s)taken subject to 204. Principal amount of second mortgage 504. Payoff of first mortgage loan 170,339.69 205. 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. 209a. 509a. Adjustments for items un aid b seller: Adjustments for items unpaid by seller: 210.City/town taxes 510.Cityltown taxes 211.County taxes 511.County taxes 212.Assessments 512.Assessments 213. 513. 214. 514. 215. 515. 216. 516. 217. j 517. 218. 518. 219. 519. 220.Total paid by/for borrower: 329,600.00 520.Total reductions in amount due seller: 210,701.83 300.Cash at settlement from/to borrower: 600.Cash at settlement to/from seller: 301.Gross amount due from borrower (line 120) 401,809.23 601.Gross amount due to seller (line 420) 389,670.72 302. Less amount paid by/for the borrower (line 220) (329,600.00) 602.Less total reductions in amount due seller (line 520) (210,701.83) 303.Cash( ❑✓ From E] To )Borrower: 72,209.23 603.Cash( Ev"] To E] From )Seller: 178,968.89 The Public Reporting Burden for this collection of information is estimated at 35 minutes per response for collecting, reviewing,and reporting the data.This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number. No confidentiality is assured;this disclosure is mandatory.This is designed to provide the parties to a RESPA covered transaction with information during the settlement process. DoubleTime® HUD-1 U.S. Department of Housing and Urban Development Page 2 L.Settlement charges 700.Total Real Estate Broker Fees $23,220.00 Paid from Paid from Borrower's Seller's Division of commission(line 700)as follows: Funds at Funds at 701. $11,610.00 to Citadel Realty, LLC Settlement Settlement 702. $11,610.00 to BEACHFRONT REALTY INC. 703. Commission paid at settlement 23,220.00 704. 705. to 706. to 800. Items Payable in Connection with Loan 801. Our origination charge $6,192.00 (from GFE#1) 802. Your credit or charge(points)for the specific interest rate chosen ($6,192.00) (from GFE#2) 803. Your adjusted origination charges to (from GFE A) 804. Appraisal fee to Streetlinks Appraisal (from GFE#3) 475.00 POC(Borrow 805. Credit report to First American Corelogic (from GFE#3) 40.80 806. Tax service to First American RE Tax (from GFE#3) 69.00 807. Flood certification to First American Flood from GFE#3 5.75 808. to 809. to 810. to 811. to 812. to 813. to 900. Items Re uired by Lender to Be Paid in Advance 901. Daily interest charges from 10/06/14 to 10/01/14 035.5658 /day from GFE#10) -177.83 902. Mortgage insurance premium for months to (from GFE#3) 903. Homeowner's insurance premium 1 years to South Beach Insurance Agency (from GFE#11) 4595.00 POC(Borr( 904. Flood insurance premium for years to 905.Wind Insurance 1 years to CITIZEN'S PROPERTY INSURANCE 1518.47 POC(Borr( 1000, Reserves Deposited-with Lender 1001. Initial deposit for your escrow account (from GFE#9) 5,803.71 1002. Homeowner's insurance 2 months $509.46 per month $1,018.92 1003. Mortgage insurance months per month 1004. Property taxes 13 months CED $407.25 per month $5,294.25 1005. Flood insurance months A per month 1006. months& per month 1007. monthsper month 1008. months er month 1009. Aggregate accounting adjustment ($509.46) 1100.Title Charges 1101. Title services and lender's title insurance (from GFE#4) 2,126.78 1102. Settlement or closing fee to Green and Kahn, P.L. $1,750.00 1103. Owner's title insurance to Old Republic National Title Insurance Compan(from GFE#5) 2,010.00 OF6-2010.00 1104. Lender's title insurance to Old Republic National Title Insurance Company $278.50 MF6-25.00;8.1-25;F9-203.50;SE-25 1105. Lender's title policy limit$309,600.00 1106. Owner's title policy limit$387,000.00 1107. Agent's portion of the total title insurance premium$1,601.95 to Green and Kahn, P.L. 1108. Underwriter's portion of the total title insurance premium$686.55 to Old Republic National Title Insurance Comp 1109. Abstract or title search to Green and Kahn,P.L. 200.00 1110. Document Preparation to Green and Kahn, P.L. 2,750.00 1111. Title Insurance Policy Surcharge to Green and Kahn, P.L. $3.28 1112. DISC/STORAGE/WIRE/COURIE to Green and Kahn, P.L. $95.00 1113. to 1200.Government Recording and Transfer Charges 1201.Government recording charges from GFE#7 207.50 1202. Deed $27.00 Mortgage(s) $171.50 Releases$0.00 $198.50 1203.Transfer taxes (from GFE#8) 1,702.80 1204.City/County tax/stamps Deed $0.00 Mortgage(s) $619.20 1205. State tax/stamps Deed $2,322.00 Mortgage(s) $1,083.60 2,322.00 1206. FEE TO RECORD to Simplifile for Clerk of Court $9.00 1207.Trust Certification/No Estate Tax to Simplifile for Clerk of Court 113.50 1208. FEE TO RECORD to Simplifile for Clerk of Court 9.00 1300.Additional Settlement Charges 1301. Required services that you can shop for (from GFE#6) 350.00 1302. to 1303. DISC/STORAGE/WIRE/COURT to Green and Kahn, P.L. 95.00 1304. LIEN SEARCH to ABRAMOVITZ TAX&LIEN SE 181.00 1305. Estimated Survey to Blanco Surveyors $350.00 1306. Unpaid Balance to Miami Dade Water&Sewer De 16.90 1307. Utility Escrow to Green and Kahn, P.L. 250.00 1308.2014 Property Taxes Escrow to Green and Kahn, P.L. 11,204.74 1309. 1400.Total Settlement Charges (Enter on lines 103,Section J and 502,Section K) 12,138.511 40,362.14 * POC(B) = Paid outside of closing by borrower **The exception rate option was used in this file * POC(S) = Paid outside of closing by seller DoubleTime® SETTLEMENT CHARGES AND LOAN TERMS Page 3 Settlement Charges Charges hatft In�S® t1L1 1 Li 'Numba Our origination charge #801 $6,192.00 $6,192.00 Your credit or charge(points)for the specific interest rate chosen #802 $-6,192.00 $-6,192.00 Your adjusted origination charges #803 $.00 Transfer taxes #1203 $1,702.80 $1,702.80 T charges 1�t in ct .an»rtln Mt0x- Than . ., r.. r ....... .: Government recording charges #1201 $207.50 $207.50 Appraisal fee #804 $475.00 $475.00 Credit report #805 $25.10 $40.80 Tax service #806 $69.00 $69.00 Flood certification #807 $5.75 $5.75 Title services and lender's title insurance #1101 $2,126.78 $2,126.78 Owner's title insurance #1103 $2,010.00 $2,010.00 Estimated Survey #1305 $550.00 $350.00 o �,,; ',Increase beta n GO nd H I[ ;algea $-184.30 or 0.00/o Charges T", Initial deposit for your escrow account #1001 $2,721.78 $5,803.71 Daily interest charges from #901 $827.75 $-177.83 Homeowner's insurance premium for #903 $.00 $4,595.00 Wind Insurance #905 $.00 $1,518.47 Loan Terms Your initial loan amount is $309,600.00 Your loan term is 30.0000 years Your initial interest rate is 4.193 % Your initial monthly amount owed for principal, interest, $1,512.73 includes and any mortgage insurance is Principal rV— Interest I— Mortgage Insurance Can your interest rate rise? 40 No O Yes , it can rise to a maximum of .00 %.The first change will be on and can change again every after . Every change date,your interest rate can increase or decrease by .00%. Over the life of the loan,your interest rate is guaranteed to never be lower than .00%or higher than .00%. Even if you make payments on time,can your loan 0 No O Yes ,it can rise to a maximum of$.00 balance rise? Even if you make payments on time,can your monthly I* No O Yes ,the first increase can be on and the monthly amount amount owed for principal, interest,and mortgage insurance rise? owed can rise to$ .00 The maximum it can ever rise to is$.00 Does your loan have a prepayment penalty? 0 No O Yes ,your maximum prepayment penalty is$.00 Does your loan have a balloon payment? 0 No O Yes ,you have a balloon payment of$ .00 due in years on 00/00/0000 . Total monthly amount owed including escrow O You do not have a monthly escrow payment for items,such as property account payments taxes and homeowner's insurance.You must pay these items directly yourself. 0 You have an additional monthly escrow payment of$ 916.71 that results in a total initial monthly amount owed of$ 2,429.44 This includes principal, interest,any mortgage insurance and any items checked below: Property taxes Homeowner's insurance Flood insurance Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender. DoubleTime® HUD-1 SETTLEMENT STATEMENT ADDENDUM File Number: GK-14-0504 I 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. I further cnthatve received a copy of the HUD-1 Settlement Statement Borrower(s) Michele Co tessa L A. Neine Seller(s) Edward Roberts Successor Trustee 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. Green and Kahn, P.L. 13Y Date: 64/) Lf I WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine and imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010. DoubleTime®