FW-15-995 Miami Shores Village
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Building Department APR 27 2015
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY:
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Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 CC)
BUILDING Master Permit No. �
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
i� (� �( �- CONTRACTOR DRAWINGS
JOB ADDRESS: IO_JAD PWi�.�b 04'\�
City: Miami Shores County: Miami Dade Zia:'33lS4;Es
Folio/Parcel#: 1121 Q S IL 22� Is the Building Historically Designated:Yes NO
Occupancy Type- Load: Construction Type. Flood Zone: BFE: FFE:
0 A
OWNER: Name(Fee Simple Titleholder):Li—A l Phone#:�� oil{
Address: t/
City: Ct�� State: ,�
Tenan Le ee Name: ni,4 Phone#i:_
Email:
CONTRACTOR:Compan Na e: V64 WV V
Addre
City:-N IAM i State: Zi
Qualifier NamK-- P X
State Certification or Registration#:
/� Cert' ca of Com' envy#:
/
DESIGNER:Architect/Engineer: / JA Phone#:
Address: //11 City: State: Zip:
Value of Work for this Permit:$ &00--00 Q Square/Linear Footage of Work: _� 10 9 (J
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work�( L4,-
'I
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ C
(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 recorq-gd:.tlotics of commencement mlist be posted-at the job site
for the first.inspection which occurs seven (7) days after the buildinq.o-ok if;j ;ys�sued: In the absence of such posted notice, the
inspection will not be approved and a re i spection fee will be charged �ONEXPIgFs°•"
6,?016 ,
U� c
•r � 1y
Signature i S` mhure
OWNER or AGENT 41, •••• °°°°e CONTRACT R
"Ry
The foregoing instrument was acknowledged before me this The fo�ggh'i�3strument was acknowledged before me this
day of 20 ,by �o+� day of C-1.10(LY� ,20 _, by
whops personall k to 1 CA eS���na , �- ersonally know to
me or who has produced as me or who has produced r` NNIA GUE r�!0>r , as
% �.+ SSIOV'••Y�
identification and who did take an��Cte� ;loslo��r , identification and who did tak-On• `��sts, oElo.• o
NOTARY PUBLIC: �p�,..Gu..•R9�'`� NOTARY PUBLIC: -�► S "''
�0016,20d' `•� : Z #EE2075 a Q
o N i e
Sig Sign A
Print: ,20.0 #EE22N75 0�� Print:
Ic.
7, Fain
Seal:
/C Seal:
STP .. Seal:
!1"t.vwl";a
APPROVED BY O�P2,t� Plans Examiner &Zoning
Structural Review Clerk
(RevisedO2/24/2014)
CFN:20150231998 BOOK 29573 PAGE 3417
DATE:04/10/2015 11:38:21 AM
DEED DOC 990.00
r HARVEY RUVIN,CLERK OF COURT,MIA-DADE CTY
Prepared By and Return To:
Karina Zuleta
Nu World Title, L.L.C.
10305 NW 41 St., Suite 229
Doral,FL 33178
File No. 14-2394
Property Appralser's Parcel I.D.(folio)Number(s)
11-2136-013-1430
WARRANTY DEED
THIS WARRANTY DEED dated March 26, 2015, by Hector Arreola a single man, whose post office
address is 665 NE 83rd Terrace #304, Miami, FL 33138, hereinafter called the grantor, to Madison
Bradley Holdings, LLC, a Florida Limited Liability Company, whose post office address is 306 Alcazar
Avenue,Coral Gables, FL 33134, hereinafter called the grantee:
(Wherever used herein the terms "grantor" and "grantee" include all the parties to this
instrument and the heirs, legal representatives and assigns of individuals, and the
successors and assigns of corporations)
WITNESSETH: That the grantor, for and in consideration of the sum of $165,000.00 and other
valuable consideration, receipt whereof is hereby acknowledged, hereby grants, bargains, sells,
aliens, remises, releases, conveys, and confirms unto the grantee, all the certain land situated in
Miami-Dade County,Florida,to wit:
Lot 1 and the East V2 of Lot 2, Block 127, MIAMI SHORES, SECTION 5, according to the
Plat thereof, as recorded in Plat Book 10, at Page 47, of the Public Records of
Miami-Dade County,Florida.
Subject to easements,restrictions,reservations and limitations of record,If any.
TO HAVE AND TO HOLD the same in Fee Simple forever.
AND the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in
fee simple; that the grantor has good right and lawful authority to sell and convey said land; that the
grantor hereby fully warrants the title to said land and will defend the same against the lawful claims of
all persons whomsoever; and that said land is free of all encumbrances, except taxes accruing
subsequent to:December 31,2014
Warranty Dead(individual 0o Individual)
CFN:20150231998 BOOK 29573 PAGE 3418
WARRANTY DEED
(Continued)
i
IN WITNESS WHEREOF, the said grantor has signed and sealed these presents a day and year first
above written.
i
I
d eal nd eli red in the presence of: �
(Witness Me
r eo a
f
.�� 665 NE 83rd Terrace#304
(Address)
(Witness Signature) Miami, FL 33138
DeA:s �r c,1 e f (Address)
STATE OF Florida _
COUNTY OF DADEE II``
I, ��ga a a Notary Public of the County and State first above written, do
her certify that Hector Arreola, who Is/are personally known to me or has/have produced a
E>L- driver license(s)as Identification.
my ha a o al seal,this 26th day of March,2015
otary Pub
My Commis n pares:
•;�4'6 .,, KARINA ZULETA
(SEAL) ?' - MY COMMISSION#EE0 1
EXPIRES April 18,2015
•,",'�l,`` FloridaNt$eryga •
(407)39"133
Warraay Deed(bdividual to Individual)
2015 FLORIDA LIMITED LIABILITY COMPANY ANNUAL REPORT FILED
DOCUMENT#L11000081733 Apr 02, 2015
Entity Name: MADISON BRADLEY HOLDINGS, LLC Secretary of State
CCO425102681
Current Principal Place of Business:
306 ALCAZAR AVENUE
SUITE 303-C
CORAL GABLES, FL 33134
Current Mailing Address:
306 ALCAZAR AVENUE
SUITE 303-C
CORAL GABLES, FL 33134 US
FEI Number: 45-2754237 Certificate of Status Desired: No
Name and Address of Current Registered Agent:
FORTUNY,ANDRES
306 ALCAZAR AVENUE
205
CORAL GABLES,FL 33134 US
The above named entity submits this statement for the purpose of changing its registered office or registered agent,or both,in the State of Florida.
SIGNATURE: ANDRES FORTUNY 04/02/2015
Electronic Signature of Registered Agent Date
Authorized Person(s) Detail
Title MGRM
Name FORTUNY,ANDRES
Address 306 ALCAZAR AVENUE,STE.205
City-State-Zip: CORAL GABLES FL 33134
1 hereby certify that the Information Indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same/We/effect as if made under
oath;that I am a managing member or manager of the limited liability company or the receiver or trustee empowered to execute this report as required by Chapter 805,Florida Statutes;and
that my name appears above,or on an attachment with all other like empowered.
SIGNATURE:ANDRES FORTUNY MGR 04/02/2015
Electronic Signature of Signing Authorized Person(s)Detail Date