HomeMy WebLinkAbout15-16808 ` CITY OF ZEPHYRHILLS
5335-8TH STREEf'
(sis)�so-ooza 1 u6� 8
BUILDING PERMIT �/
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 16808 Address: 5812 14TH ST ,
Permit Type: MECHANICAL ZEPHYRHILLS, FL. ',
Class of Work: A/C CHANGEOUT Township: Range: Book: ',
Proposed Use: NOT APPLICABLE Lot(s): Block: Section: 'i
Square Feet: Subdivision: CITY OF ZEPHYRHILLS �,
Est. Value: Parcel Number: ',
Improv. Cost: 4,970.00 OWNER INFORMATION
Date Issued: 12/07/2015 Name: KELLY J NELSON
Total Fees: 60.00 Address: 5812 14TH ST
Amount Paid: 60.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/07/2015 Phone: (813)778-7577
Work Desc: A/C CHANGE OUT 3 TON
CONTRACTOR S - APPLICATION FEES -
KI EY CENTRAL EATIN & C C C NGEOUT 60.00
�
� � ^ �� r� ��
' � ��
Ins ections Re uired '
D CTS INSTAL ED
� DUCTSINSULATED
FINAL .y Z�=�L�`( -- l�
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c)the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reins ection whichever is reater for each such subse uent reins ection.
P � 9 ► 4 p
NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this properly that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
"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."
Complete Plans,Specifications Must Accompany Application.All work shall be perFormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
�
O TRA R SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
e�saeo-oo�o City of Zephyrhills Permit Application Fax 813-78p-0021
Bultding Department
Date Receivad phane�ContacEfor Pernitt#�n
Owner's Mame L{ /v-�' s� � Owner Phone Number t. �����"" 7��� �
a � �
Owner's Address `�� ra~ � � ` � Owner Phone Number
Fee 8lmple Tltlefiolder Name � � Owner Phone Number '�- �
Fee Stmple Tltlehold�ar Addresa
JOB ADDRE'SS � �--. � �� LOT# ���
SUBDIViS10N �� � PARCEL ID#
� , (OBTAINED FROM PROpERTY TAX N0710E)
WORK PROPOSED - NEw CONS7R ADD/A�T � S1GN [� Q DEMQt,ISH
�:- INSTALI. 8� REPAIR
PR4PQSEDiUSE Q SFR [� CQMM �,� �OTHER'
TYPE OF CONSTRUGTION Q BLOCK ` Q FRAME �, STEEC Q
DESCRIPTIQN OF WORK ' � ��� ��� �� L v ���
BUILDtt�G SIZE �� � �" SQ FOQTAGE C,-� HEIGHT .��`�
QBU1�DtNG � � VALUATIOPi:6YF'TOTAL CONSTRUCTiON � �
QEL�+CiR1CA! �� AMP SEF21110E Q PROGRESS ENERGY Q W:R.E.C.
QPI.UMBlNG - - . �
�„.,, �
QMECHANtCAL $ •�� �L� VALUATI4N OF MECNANIGA�[NSTALLATtON.
�o, ..� �
QGAS Q ROOFlNG .Q SRECIAI.TY � OTHER
FINISHED FLOOR ELEVATIONS ��� FI.00D 20NE AREA QYES NO
i
. 8U1l.OER COMPANY~ ` �
i SIGNATURE REGISTERED Y/ N FEE CURREP Y/N
� Address = � , Lfcense# �� �
�
� ELECTRICFAN= , ::COMPAFtY .� .. , .
; SIGNATURE �' REGISTERED Y/ N FEE CURREk' `Y/N
; Address ' • . , ' � - License:#:� �
P�UMBER - CaMPANY _._ � .� _ .
SIGNATURE" " ' �RE(31STERED,. Y./<.N�. . FEE CURRED . . ' Y/N " .�
Addreas � License,# � �.
� f /'' �
MECHANICAC: ' COMPIWY I fh/S� -C. �V �
� 51GNATURE t ' � REGIS7ERED , Y/ N � FEE CUFERE� Y/�N'
Address'` - � , . . - License# ,. . 1��— - �
t3THEEt � ' - � - `;GOMPANY n .
SIGNA7UitE ' � � � ' " ' ' ' REGISTERED ' Y/ N... FEE CURREA Y/N. ,
,.. . .. . -
Address ' . . . ' License# �� �� �
RESlDEN7'IAI:,;• Attac�i{2),:Plo#i:Platis;.{2}sets�.of�Bullding�Plans;{1}sef ciftEiiergy>Fa'rms;}z-O-IN'Feritiit for new ainsttuctton, - '
•-Mlnimum�tenK(,1.0)�workingydays;a#ter,;subrrilftal date:'Requlred onsite,:�Constriicdan�Plans;Stormwater'Plans w/SIIYFence installed,
.u.Ju.•Y':.�,�•_, ...!.. .�rt�._^,.nv.. � _
Sanitary Faclllyes;&:�1,�,dumpste_r,�31te�Work:Pertnit for sutidiVislohs!large.proJech's, . " • , ' -
GOMMERC#AI. Attach{3)comptefe seE"s"of Bu3lding Plans plas a I.ife Safety Page;{'9}set of Ene'rgy Farms.R-O W Petmit for rtec�i constructton,
IMinimum ten(10)working days'after submittal dake. Requlred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary FactliHes&1 dumpstar.Slte Wark Permit for all new:proJects:_All commercia!requlrements.must meet camptlance
StGN PERMIT Attactt{2}sets of Eiigl%�eered=!?la�is.;-:..; , ; n _ ,
' ••"'PROPERTY SURVEY required for aq NEW constructian..
Directian�: - -, .,,, - .
� Fill out applicatlon completely.
Ownsr&Contractor sign back of appiicatton,natarized
If over 32500,a Notice af Cammencement is r�quired. {AIC upgrades over b750dj
'" Agent(for the contractor)or'Power of Attotney�(fo�tFie owner)would be someane with notarized letter from owner authorizing same
OVER THE COUN'iER.PERMi'F'TlNG• -- {Front af-APPIIca�on-Oniyj_. __ . ' t -- - , _ •- • -j �
Reroofs ifshingles Sewers Service�Upgredes..A/C�: �...F,.ences.(Plof/Sur,vey/Foatage) •; �C;,�':.:;._ .. .
.__� � _ _ -- !`;e;�;.',.� ��. :�a`. �`� " ;t �' • 'tt ,. �. � _.. �r_1 -,. . .
Driveways-Nat over Counter if on public roadwayis.:needs:ROW,�: " ,_ z b� - . ���:t - ... � . ' , �- ,
� ''�`� � , . , �"IG'Y.- ;c!�j •�, .�i:,, . . ,, .�., • �'" ,
, _ ..,, . . , � -_ ;r.�t, `•`:.. � ' i . ._... . . .. . <. . -
.....� ,.._:v�.,rr.._ ....w<<.T.. ...�.. .. .
. A
f'.
NOTICE OF DEED RESTRICTIONS: The undersigned,unders�tandsz#h�t;this:�p�rml�,:may,;be,subJect to"deed",restrlctions"� � ..
which may�:tie=more:r:esttictive-th�n�County regulatfons:�TFie undersigned��as'"sumes��responsibllity'for�'compiiance``with any'" `'��"` �
applicable deed resMctions. :. : : � � • � . � .,. _: -- � - � -�
UNLICENSED �CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: =-If the ovmer�has��hiredJ�a �conhactvr or
contractors to undertake work, they may;be�.r.e�quired:.to.,be,ltcensed.ln accordance.with s.tate�:and•local�regulation.s.::•Ifrthe�= � � �
contractor l� not licensed as°requlred;tiy law, botff'the owner and.�cont�actor=may�be�°clted�for�a�misdemeanor vlolation
under state law. If the owner or Intended-;co.ntra�,tor;are;uncertaln as to wh�t IlcYenaing.requlrements�may-:epply��for,�the��� - -�- n--
. �.,. .�,. ., -
Intended work,they are advised to contact the�Pasao.County Buliding-Inspection:Dhilslon--Llcensing�Section at 727-847-
8009. FurtFiermore, If the oviiner has'�Nired'a conUacto�`or contractors, he Is advlsed to have the contractor(s),,_sign ,
portions of the °contractor Block".of,this application for_whlch they, will�.be_responslble.- If you, as..the oviine�`sign'as'4he� �
contractor, that�may-be an indicatlon that'he�1s not:properly'licensed and-is'not entitled to perntitting pri�lleges in Pasco �
County. r..._: F:_� ..
TRANSPORTATION-.IMPACTIUTILITIES�IMRAC`�ANb RESOURCE RECOVERY�FEES:The undersigried understands "
that Transportatbn Impact Feas and.Recourse.RecoVery.Fees tnay•,apply;fto�tf�e''constructlon of new_buildtngs,?change of"� -"-`� � ;
use in existing buildings, or�_expansidn��of�ezisti�i�,6uildings, as speclfled.in P�scv County Ordinance number 89-07 and ''
90-07, as amended.,.The undersigned also,understands, that:'such fees;;as�may::�e::due;:wllF,.be tdentified at the�time�of}� �� � �
permilting. It Is fu'rther understood that Transportation Impacf Fees and;Resource:Reco�ery�Fees�.must be pald prior to
rece�Wng a'certiflcate_of occupancy"•or flnal=powe,r.;retease: :If�the.proJect.:does�:not invotve.a:certiftcate of occupancy o�"��� -
final power:release;,tlie'�fees mu�t'be paid;p�l'o.'r to,permit Issuance. Ft��thermore;�If:.Pasco,.C.ounty�INater/Sewer;lmpact � . .. '
fees are due,they_must be..:pald prior#o.permit_.Iss4ance=ln:.accordance with appllcablePasco��County�ordinances. • ;
CONSTRUCTION CIEN'LAW(Chapfer 713� Florlda Statut�s�aa amended): If valuaHon of work ts$2,500.00�,or,more,.1- �- - �t� '
certify that I, -#he applicant-,:�have�been provided•�wlth--a-copy�of�the��"Fiorida� �onstructlon� Lien".Law—Homeowne�'s
Protection Guide° prepared by tlie Florida Department�of Agriculture and Consumer.Aifairs. If the app8cant is someone :
other than the bw�er", I certffy that..l;.have.ob.taine`d>a"copy;of..the,above.riescribed.rlocu�ent:and.promis�in,good:,faith.to .r
deliver it to:tlie'own"er"'.p�ior`to�commencement`'� � ' -' . � � . �
CON7RACTOR'S/OWNER'S AFFIDAVIT: I.certlty:�:tliat�ail�the,information:;imthi� applicatlon is accurate and that all work
w(II'be done in compliance w(th all.applicable�laws reguleting construction� zoning and�,land�development. Applicatlon Is
hereby made to,obtain .a.permit;;Co�do_v_uork,.,and�li�stallation es indtcated:-�.•�i� certfty that no work�or installation has
commenced p�for to Issuance of�a permit"and that`.all work will be pertormed�to meet standards-of all laws regulating�_
construction, County and City codes, zoning regulatlo.ns, and land development cegulatlons=ln the.jurtsdtction.- I al'so ,
certify that I understand that the regulations of other government agencies may�apply�to the intended work, and that it is
my responsibility to identffy•what,actlons 1 must�take:to bedn:.compllance. Such agencies include but=are.not Iimited ta � � �
- Department of E�lvironmental�Protectton'=Cypress.'Bayhead�, Wetland Areas and Environmentally Sensitive
Lands�WatedWastewater Treatment. r_ „ �
- Southwest Florida Wate� Management :l�tstrict Wells, Cypress. 9ay.heads;� Wetland Areas� Alter�ng �
Watercourses. '
- Army Corps of Engineers-Seawalls, Docks, Navtgable Watervvays. :
- Department of_•Health�'.B,,Ret�abll(tativ.e Secvtces/Env(ronmental .Health Unit Well.s� WastewateriTreatment, � !
Septic Tanks:. � '� - � - . '
- US Environmental Protection Agency-Asbestos abatement. �
Federal Avlatlon:AutMorlty.;Runways. , �
I understand.that the following.restrlctlons apply to the use of flIL•
- Use of fill Is not allowed in.Flood,Zone"V"unless expressly permitted. ;
- if the #fll materfal=ls 'to �b.e used:in:�Flood Zone. "A", tf. is understood that a drainage plan addresstng a
"compensating volume" will be submitted at#ime of:permitting which is prepared by a professional engineer '
Iicensed by the State of'Florida: � � � = - .
- If th� flll-materlal�is=to be used in Flood Zone 'A° ins connection�with�a•��ermitted building using stem wali
' construction, I certlfy th�t fill:wlll:b.e�used only.to.flll the a�ea within the�stem vvall.
- if flll mate�ial is to be used�in any a�ea; 1"�certify that .use of`such flll will not adversely aRect adjacent ,
propertles. If use of fill is found to adversely:�ffect adJaEent��pr�pertleg,,the owner may be cited for�lolating '
the condifions of the building:perniit Is"sued�under the�attached_�ermit appl(cation, for lots�less=than.one (1)
acre wfiich are elevated�tiy flll; a�►englneered dralnage plan ts requlred. •
If I am the AGENT FOR THE OWNER, I;.promise in good faith to inform the�owner of-the permitttng condftions set forth In ,
this aifidavit�prior to commer�cing construction. �I undecstand thet:a-separate permit may be requtred for elecMcal`work, _ .
,�_.-�--_
plumbing,.signs, wells,.pools;. alr condltioning,.gas,, or�otMec Install�itlons not•spec�laally included�tn.the application. .A
permit Issued shall be constcued to be°a�Iicense°to�proceed with the work and not-as:authocity to,violate..cancel, alter, or
set aside any�provisions of the technlcal codes;�nor shall Issuance�of a.permlt.pcevent the Bulldirig Official from thereafter
requiring a conection af,ercors In.plans; constiuction orviolatlons of�any codes.� Every�p�ermlt�lssued sfiall become invalid
unless the work authorized.by such permit:�ts-cornmenced•wtth(n sfjc.months of permit Issuance, or if work authorfzed by
the perm(t is suspended�or.aba�doned�for:a;period;of�six,�)�montfis,:aRer the tirt�e the�work�ts commenced. An extension
_ may be requested, In.writing,.from the Bullding,Official for a perlod�not.to exceed�ntneqr��(90) days a�d-will demonstrate _
justifiable cause for:the extens(on�. If work ceaa�s:fio�ninety.-(90)cons.ecutive days,-.the job�ls.conslaered abandoned'.—�
1NARNING TO OWNER: YOUR..FAILURE�TC3.RE�.OEtQ_A;MOTICE:OF.-COMMEMCEMEMT.MtAY RESULT IN YOUR
PAYING TWICE;FOR IMPROVEMEN�S-TtJ X�OUR:PR�PER�7Y: I�°YO.U�1�1'�E�ID:TQ'�BTAIN�FIN�At�E1NG;�C.ONSULT
WIT U D � AN A O OR�� OR� ��� OU �` � - � E
FLORIDA JURA'�(F.S;11 .- ' _ , � �
OWNER OR AOENT CONTRAGTO �
Subscribed and swo afflrtn efore me this Subecrlbed'and' (ot' rmed)�before me th18
by ... .
Who Islare persona kn to.me or haalhave produced IMfo.is/are p.eraonallyknown•to me or ftas/have•produced • -
as Identlflcatlpn. as Identlflcaflon.
� � . �
NoUary Public � Notery Public
Co Isslon No:'` Comrt�l n�No.
�"'�""'�•, JOEL E.BACON
Name ot Nola , _t6m�IP� 2018 Name of o��.'�d,�Q6 . ped �
=�a• �o; Expires June 29, :.; .: ommission#FF 137075
`;�;;-�::;:' e�,�,,�,ih�ar,rrFe�nlnew�noae(q385•7019 ;��,:�; Expires June 29,2018
�'+�-�"x"`s'�'4"Y`�j°'"`°�'�'�� - �'•'F,,prk�„°�.�`� Bond�dTlwTrryFuinlnsucnaB04385dOt�J
.....s,r.�uw
� �
� ��� dMB Approvai No.25D2-0265
�� � A.Settlement Statem�ant(HilD-4)
t
B.Type af Loan
i.�% FHA 2� ftHS 3.� CANV.UNINS. &�N�Or. T.t.wnN�unher. 8.tdwkgage�freurancaCaeeNumher.
� a.� vq s.� CONV.lNS. ���4 20501510659D 083-8298622-702
1
I C.ilota:Tiih tarm is tumtsAed to 91ve yau a ttaVs�azct a!acttta!aeCtemsnt costs.Amounts pald tn apd b1`the aetttemant e6�t are shwm.ttams markud'(p.a.a7"wero oaid ouiside
the doaing;thay are shmm hera for Intwmetionn!putpo�ea Md ere not Indvded In tha Mtah.
� p,N��r�e 8 qdE�nu o{gonvw�� E Nam�i Addrnn ot$d7�r. F.Nam�6 AAdraxi ot Lend�r.
� Kelfy J.Netson,a singie woman Mlranda L.Bums,a single woman F1rst Guaranfy Mortgage Corporation
375Q8 PicEceis M(I!Avenue 524 NVY 22nd St.Ag�.6 t9Q0 Gatlows Road,Snite SDO
Zephyrhilis,Florida 335q2 Miaml,Florida 33127 Tysons Corner.�rginia 22192
('a,ptop¢tfj(,xet{on; N.fiettlsmeMJigenk t Sottlemont Onte:
6B1214th Street Magno!!a Tltle Agency,LLC December 4,2Q15
' 2ephyrhlls,Florfda 335d2 37851 Metidian Avenue
Pasw Counry,Fiorida Dade City,Florida 33525
, 362-d37-4875 fax 352-437�4880
� PGcc W&sl8�ma;tt
Magnoiia Title/�gency,L.LC
37959 Meridlan Avenua
pade Cftyr,Ftcrida 33525
Phone:{352)437-A875
J. Summary of Borrower's Transactlon � ' K. Summary af Seiler's 7ransaction
16p.Gross Amount Dus From Barrower: 400.Gross Amount Due To Se(ler:
101. Contraci$eles P7ice 99 8t}0.00 401. Corittacf Sstes Pttce S9 80DA0
102. Persanal Pro e A02. Perxoaa!Pro
103. Sett�ement Cha es to Borrower line 1400 23 969.15 4D3.
Ad usfinents for Itams Paid Seiter In Advanae: Ad'ustments forlmma Pald b Seller in Advence:
1�8. Gi (Town 7axes 406, Ci !Town Taues
107. Coun !Pat(sh Taxes 4Q7. Coun /Parish Taxes
108. 2075 Assassments C?ec 4 2015 thru Dec 31 2�15 4.57 qQ6. 2015 Asssss�rients Dsc 4 2U16 thru Dec 31 2Q15 4.57
109. 2016 Taxas t}ec 4 2015 thru pec 39 2015 121.32 409. 2015 Taxes Decq 2a15 thru Dac 31 2095 12i.32
110, 20SSAssessments 59.52 410. 2018Assessments 58.52
424. C3ross Amount Due fram Barrower: 123 74.b6 420. Gross Amovnt 6ue fo Sei�er. 100 085.41
200. Amounts Paid b or in BehaN of Borrower. 604. Reductions��Amount Uue to Selter:
2d1. De osit or Eamest Mone 5oD.00 501. Excess De osk see insWcdons
202, prinot at Amount of New Laan 112 576.00 502. Settlement Cha es to Seller Line 1406 7 745.63
203. Existi loan s taken sutt'ect to 543. Existin Loan s taken sub'ect to
Fayoff of�Srst Mortgage Loan(tnterest Tfirough
204. Seller Contribudon to Buyer Closing Cosls 5,5QO.QD 5U4, 1214/15)to Suncoast Schoo!Fedsra)Cradit 47,A54.7'f
Union
�, Payoff ot Sewnd Mortgage Loan to Georgia M.
205. Owners Titla Poltcy Gredit Prom 8eqer 674.A3 505. Fogle Trustee ofi the Dorothy S,Mifler 34,0�0,00
lrrevocable Trust FSO RCF
2�. 50&. Purchesa Mone Mo a e
207. 507. Seller ConUibution io B r Closin Costs 5 5fl0.Q4
M 248. 5D8. Ownara TiHe Po11 Credft From Seller 574.43
Ad'ustrnents tor Items Un ald h Selker. Ad usbnents for items Un aId b Setlar:
210. Ci !Tawn Taxes 510. Gi t Town Taxes
211, Coun /Parlsh Taxes 571. Coun! /Parish Tsxes
2'I2. Assessmants 512. Assessments
Z13• 513.
214. 31q.
22D, Total Paid b /tor 8orrower. 199 95D,43 52Q. Tota!Reduatlons Sn Amount pue setter: 95,274.77
300. Cash at Setttement from 1 to Borrawer. 80U. Cash at Settlemeat to!ham Seller.
341, Gross Amoont due fram 9atrowar lino 120 923 474.56 601. Gross Amount due to Selier line 420 t00 a85.47
302. I.ess Amnu�t Pald h ttar Sottawer Itne 224 t9 tb0.�i3 802. Less Reductions Amouni due Setler line 520 95 274.77
3US, Cesh From Horrower: 54,324.13 603. Cash 7o Sallar. ;A,810.64
'fhe Pubifc Repo�ing Burden for this ca!lactton ot Informa@on is estimated at 35 minutes per reaponse for cotiecting,2viewing,and reporting the data,
This agency may not callect thls Information,and you are nat reyutred h>compSete this form,unless ltdfspiays a currentiy vaiid oM8 cantro!num6er.
No confidsntlatiiy is asaured;thts dlsctosure is mandatory.7his[s designed tn provide the parties io e RESPA covered transactian with infocrostian
dudng the seitlement process.
I
Pravfous edltions are obsolete Page 1 ot R HUD-�
' December 3,2015 5:44 PM
SstNement Date:December4,2D95 Lflan Num6er.2010'f5105590 �ile Numbes:45-09-44
L Settlement Charges Paid fram Paid from
7QQ.Tota!5ales i Hroker's Gommission:$4,985.D0 Horrower's Sellet's
Divtsion oE Cammtssion Une 7d6 as follows Funds at Faads at
701, 2 497.54 to Centu 21 Bill N a Real Settlement Settlemsnt
702. 2 497.54 ta Centu 21 Bill e Real
7�3. Cammsssion Patd at Sat#Eement �g9��4P �
( 880. tAems P bIa in Connect3on wifh Loan: �
BDi, Qurorigination chatge (from GFE#1) I
$3 095.&4
802. Your crsdit or charge(poinfs}for the spec'�'ic iaterest raie chosen {from GFE#2) i
� to Suerez Home&Finance Co . 1 106.62 I
803. Your ad usted ori ina6on eha es from GFE#A 'I 989.22 I
894. Appraisa!Fee {frpm GF�#�31 '
to Gcester VI�S o 557�.d0 b 8orrawer
805. Credit Re rt
806. TaxSBNlce
807. FInDd Cettification from GFE#3 90.OQ
848. Braker`s CreSR Report � (from GFE#3}
to Suarez Home 11ao CredR Pluc 6fi.31
9DD. Ibams Re ulred b Lenderm be Pafd in Advance:
961. Dai inSetest cha e fmm Qec 4 2015 to Jan 1,20i6 14.65D3 1 da fQr 28 da s from GFE#1 q 410.21
902, Mor�age lnsurence Fremlam {fram GFE#3)
to De attment of HUD 7,93820
903, Homeowner's Insurance tor 1.00 years (from GFE#11)
to Seouti Frst 5,044.00
184D.t2eserves De osited with Lender.
1001, lni8al depwlt for your escrow account (fram GF�#9)
to F(rst Gueran Mo a e Co raUon 967.36
1002. Homeownsts Insurance 4 months $87.0� er month 348.00
1003, Moft a e insurance $77.82 ar month
1064. Property Taxes q months(o�$154.84 per manth $619.36
1900,Titie Cha es:
1'I01. Tit(a servicas and tendefs tifle insurance from�F�#4 829.87
i102. Settlement or Closing Fee
to Me nolia Title A an LLC 45p,00 250.Q0
1103. Uwne�'s TISte Insura�ce{old Republic Nalfanal TtUe insurenca Gompany) {irom GEE#5)
to Ma nolia�f�e e� L�G 574.43
1104. Lender's 7ltie Insurance(Old Republie Natlonal TfUe]nsuranca Company)
to Magnolia Title Agency,LLC
, - Lenders Prsmfum �gg,�7
- Endorsement 8.4 g25,qp
- Endorsement FL Form 9 S6B.80
110.5. Landar's Title Poli Limit$112 576.00
1106. �+nrne['s TiFie Foii E.frnit tw99 9DO.Qp
11fl7. A enYs Por�on of fhe Tot�1 iitie Insarance Premium $528.01
1708. Undenvriters Portion of the Tatal TiUe Insurance Premium Zg,�g
1709, Title Search Fee
I to OEd Re u61ic Nat3ona!Trfla insuraaca Com an �r�,pa
1110. Sfate of Florida Sucoharga
' to Old Re ublfc National Title Insurance Com an g,28
1111, Munlcipal Llen Searoh
ta S lins lien Seatch Inc. ��fl�y
1200.Gavemmant Recordin end TransTer Ghar es;
72D1. Govemmant Recordin C es from GFE#7 1�3.50
1202. Deed$l9.50 Mo a e$96.OD Releases 50.04
9203. TransfetTaates fromGFE#$ 8i925
1204. C' /Coun tawstam s Deed$0.00 Mort a e$0.00
1205. Stata taxlstam s Deed 699.30 Mort a e$394.90 699.36
12D8. lntanglble Tax
ta Clark at the Circutt Court �2�.��
1207, Other Tax 2
1208. Recording Fee Death Certificate of ere�da Sue Bums (fram GFE#7)
to Ma nolia 7E�ae A on LlC ,��.�a
1300.Addit7onaE Sottlemetrt Cha es:
1301. Re uired services that ou qn sho fnr from GFE#6 275.00
� i302. Survey
' to Eddie P.Jenkins Sun+e'n &Ma in Inc. $275.00
�I i303. FesY tns ction
130A.
oc$O,pO b Seller
9305. 20i5 FaXes
, ta Pasco Coun Taac Ca(tector 1 658,OG
� 1306, Total Reha6(14,759.80-287.6D•2890.p0)
to F(rst Guaren Mo a e Co oretfon '!1 566.3Q
II 1307. int�al Blsbutsement to F�ank Naoker 97.6U ?g��a.
i9D8. Initiat Disburseme�t to A(Coton 890.p0 2 890.40
I'
i400.Tota!Setilomenf Charges(Enter on•iine 7Q3,Secqon J and 8na 502,Section K) 523,389.95 S7,7d5.63
Prevlous editione are obsolste p$ge 2 pP4 HUD-�y
Qecember 3,2015 5:44 PM
_ ___ �
, �
, Settismeat Date:�ecam6er 4,2a15 Loan Number.20101510558� Fi�e Nttmbec 15-Q9-Q4
Comparison of Good Fatth Hstimafe iGFE}snd NUd Cfiaraes -
Chalges ThatCannotlncrea9e HUD Line No. �ood Faith HUD
Estimats
Our ori ination che e #801 3 316.DH 3,Q95.84
Yout credit or cha e o2nts for 2he s ecitic Intsrest rate chosen #8Q2 -965.90 -1 106.82
Your ad usted ori ination cha es #803 2 350.18 1,889.22
7ransfertaxes #12d3 1.30728 89925
Cl�arges Th�t in Totat Cannot Increase More'i'han 10% HUD Line No. GO�{�mat�e HUD
Govemment Recordina Cha es #1201 250.00 113.5�
A raisa!Fee #Sfl4 450.00 570.00
.Flood Certification #807 70.00 1�.00
BtokePs Credii Re art #866 0.00 65.31
Mort a e Insurance Premium #902 1 93520 1 93620
Total 2 646.20 2 896.0"!
Increase ketween GFE end HUD Char es 44.84 1.8&°!0
Good Pafth
Charges That Can Chen@e HUD Line No. HUA
Estimate
I Initial de osit tor our escrow account #1001 967.38 967.38
D interest cha a f�om Rec 4 5015 to Jan 9 2d#B 9d.6503 1 da far 28 de s #9Di 424.86 410.21
Momoowners Insurance #903 1 Od4.00 1,044.00
Tl�a sarvices and lender's Uf]a insurance #11�1 1,475.d0 629.8�
Owner's'Fltle Insurance #11D3 800.00 574.43
�v�ys #i302 26dA0 275.D0
ILaan Terms
Your int8ai toan amount Is $t i2 576.Od
Your Ioan term Is 30 ars
I Yaur I�ri1ai irrterest rate ts 4.75%
Your Initlal monthfy amount owed tor principal,interest,and §665.07 Encludes
any mortgage insurence ts [X j Pdncipa�
(XJ Interast
X Mort e e Insurance
Gan your lntetesi rate rise7 (X J No. [ ]Yes,ft can dse to a msximum of=lo.The first changa wi0 ba on
' end can chenge agaln every aftet .Every
change date,your lnYsrest rate can increase or dacrease by�%.Ovef tha life of
tha laan,your intersst rate is guaranteed to never be LOWER than_„_%or
tilGiiERthan %.
Evan if you make payments on tlme,can ypur loan batanca [X J No. [ ]Yea,ft can hsa to a me�dmum of$
rtse?
Even If you make paymenEs on dme,can your monthly [X)No. [ )Yes,the first inaeasa can be on and the manihly amount
amount owed far prirsclpai,Yniernsf,and mortgage `owed can rise to$
Insur�nce rise? Tha maxfmum It can ever rise to is 5
Daes our loan have a ra ment nut ? X No, Yes, flur maxlmum re a ent enalty is S
_ poes your laan heve e balloon paymeni? [X]No. [ ]Yes,you have a balioon payment of$ due in�years
on
Totat monthly amount owed fncluding escrow account ( ]You do nat hava a monthJy escrow payment for Etams,such as prppsriy faxes
payments and homeawner's Insursnce.You musi pay Uaesa items dtreciiy yourseif.
j X]You have an additional monthly escrow payment of$24i.84 that tesuJts in a
totat tnfttat monfhiy amount owed of 5906.91.ThIs lndudes principei,interest,any
mortgags Insuranca and any ftems checEted below;
[X j Propecty taxes ( j
[ J ptood insurance ( ]
X Homeownar's tnsurance
Nole:If you heve eoy questions about the Sedlement Charges and Loan Terms iisted an this form,please contaci yaur tsnder.
Previous ed(Qons ere obsolete Page 3 of-0 y�p_�{
December 3,2015 5:44 PM
i
, SeNlement Date:Decemher4,20i5 Loan Number.2D1016105590 File Number.l5-D9-04
B ers
Kelly J.Nelson
37506 Pickets MIII Avenue
Ze h rftills Floride 33542
Sellers
Mlranda L,Bums
� 524 MN 72nd St.Apt.6 �
Miami Florida 33127
Pro e Addresses
5812 14th Street
Ze h rhilis Florida 33542
II have qrefully revlewed the HUD-9 Se�lement Sptement,and to tha best of my knowiedge and belief,it Is a true and accurate statement of all
recelpis end disbursements made on my account or by me fn thfs trensactlon. I furiher cartify that I have received a copy of HUD-1 Sattlement
StafamenL
Bnrrawer. ���UU Saller.
Kelly J.Nelson Miranda L Bums
I have reviewed the Closing D�sclosure,the settlement statement,ihe lendsfs ciosing InsWctions and any and all other forms relaBve to the escrow
Tunds,inUuding any disclosure af the Florida Utle insurance premfums being paid,end I agree W disburse tFie escrow funds in accorclance with the
tertns of thla transactlon and Florida law.
i SettlementAgent 1"' / , /� C�� Dete: Decem6er4,2015
Mary G.CesV
WARNING: It le e atme ta knowingiy make isise statements to the Unf�ad States on this or eny olher similaz form.Penalties upon conviction can
fnGude a fine and ImprisonmenL For details see Tryle 18 U.S.Code Sectlon 10�1 and Section 101D.
Previous'edifions are o6soleie Page 4 of 4 •
H U D-1
' December 3,2015 5:44 pM
� :s ers. • '
,c�y,�. • _
�75w ard�c�61a avonua '
2 tRv.Flaide 9J542
• SoNers
td aL eurttl �
�F+2�NW7�nd5LApt6
Wmn FlwiEa SiSR7
:P .Addmssas! " .
2 74tlt 9f�t
tliIlls HM{da 335d2
I Ivw cwt�y�avtmred tlu kU0.1 BetltemeniS�nC m�d tp tha hea!Of my knrns'kd4e cM be8r1,@ Is a tme m�d 0ea+tete S�tsnertt ot¢U
54�itanenC ���made an my u�m!abyrre In 9�f�hatuaclion.1 N�r atGfy tlui 1 tmve cecdwd a mpy of HU6-1 6atl:emant
Se➢gr,�'
k6a a L fivrt5 '
I have�evtet�'ed Bre CfoslnB Utsc(osure.HiesatAament statemenL IhaRndefa msfn0 inshucllona end mrya��oNet fomta tala6ve In iha ea�ca
funds.Indudin9�nYdcdusum af ths FMifda tltlC Inamsn�pinnWrtw beM9 Pald�eM t agree b dttbuno tln eccvx fial6s in e�eudanoeivdh 1ke
Wms af Ilds trairaabn wid F�wMa law.
Seffiamc�d/lyent �ab: �ecemDer4�2016
rdery a.cesbo
intlude e Po�e and�m�6'mdm fafsa eta�(p tl�lMked.States on 9�b oi enY Wtmra§n8��rm F+anaqtea Upam m�NGlon�n
�bO+x�re++t Por d�a sea TiEu iB VS.Code Sc�rn 7007�d&edion t0i0.
Re�Mw odmons a
re obsoble Page 4 of 4
OocomDer 3,2p15 21g pUl
I
j/ • �
�,a,,��2 ��.Kinsey Cent�al ! � _ �
���-��v Hea��Air-Conditioning, lnc. '
P.O. Box 2209 !
Zephyrhiils, Florida 33539-2209 , ' �
(813) 782-2300 cA co5as2s �
�� �-TS"� � i
�
a�� �
s c�-� �
� _ a.. � ` "�'"'�' . -
�
. �
, ❑ Esrin+u►� �
NATURE OF ❑ CASH ,
1
REQ�sT� � CHARGE f
. �
�
QUAN. PART NO. • DESCRIPTION PRICE AMOUNT I �
i
. !
. �
�il-�-, /. i ..
� � l��- �d�o� � ,
� ..�. j
r +
� �
� {
I .
� i .
!
I
SERVICE'PERFORMED mnu. �
. u�T� (
. �cN.
i
��
� � ~
ActiagooflS7Gw�lbemtdeaasllimpiaidbaienoeaa9c3Ddaye,wfiichisaa�ualpmomDgpate TAX
ai
of 18Y.sppiied to pest�e balaaooa.�l�tomais liable tor aey d�ages i¢a�d in coffatingttris bID.
. i
7iFaa��al �CASH�°Of�`E"01i-. Torn� I I
• f
{
TECHNICIAIV CUST�AER'S SIGNATURE �
I