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Home My WebLink AboutOwner Builder Affidavit R E C E I D SEP 2017 Planning&Development Services Department Building&Code Regulations 2300 Virginia Avenue Fort Pierce,Florida 34982 �I (772)462-1553 li OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT F.S.489.103(7)EXEMPTIONS State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that 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 provide direct, on-site supervision of the construction yourself. You may build or improve farm outbuildings, a one-family or two4amily residence for your use and occupancy. You may.also build or improve a commercial building at a cost not exceeding $75,000.00 as long as it is for your own use or occupancy.You may not build or improve said structures for the purposes of selling or leasing that building. If you sell or lease a building you have built or improved within one year after construction is complete, then a presumption is created that it was built or improved for sale or lease,which is a violation of this exemption. You may not hire an unlicensed person to act as your contractor or to supervise people working on your building; it is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal.licensing ordinances. You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. Your construction must comply with all applicable laws,ordinances,building codes,and zoning regulations. Initial MJ_ I understand that the building official and inspectors are not there to design or give advice on how to meet the minimum code. Initial M I understand that as an owner-builder that any contract disputes with sub-contractors and I must be handled in a civil court with the advice of an attorney. This department will not mitigate any contract disputes. J Initial _ I understand that if I compensate any person or company for work performed they are required to be licensed in this jurisdiction. If for some reason they do not possess a license,I may be responsible and liable for the cost of the license. Initial /hf I understand that if any person that is unlicensed and uninsured gets injured on my construction project- they may be entitled to workmen's compensation. I could be held liable for all doctor,lawyer and related medical cost,which could include loss of wages during recovery from their injury. initial- To qualify for this exemption under this subsection,an owner must personally appear and sign the building permit application and initial the above. I hereby acknowledge that I have read and understand the above disclosure statement and that I further understand that any violation of the terms of the owner/builder exemption shall be reported by the Building and Zoning Department to the Florida State Department of Professional Regul on. igned an ac owledged on this day of��of 20 LZ. I Owner uilder Signature STATE OF FLORIDA COUNTY OF 1.V II The foregoing-instrument was acknowledged before me thisa day of 54 20,11 by h„a tk Sc,H�n $Z who is personally known-_., tome,or who has produced as identification. �Not A G'\v R DEANNA MARIE GNENS Sign Type or Print Name of Notary ji 3 MY COrISSJpN'#GG 022023 Title:No Public 5 L`. FXPIR tuber 16,20.0 wry Commission Number bonded Thnt Notary Public Underwriters SLCPDSD Revised 05/15/2014 I I• i I� A. U.S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT B. TYPE OF LOAN SETTLEMENT STATEMENT _ _ -- Liberty Title Company of America,Inc. 1.;T FHA 2. FMHA 3. !% CONY.rNINS. 1844 SE Port St.Lucie Blvd -VA 5- 1 ,CONV.INS. Port St.Lucie,Florida 34952 772-335-7474 fax:772-335-7373 e.F eNurtSe r.loan Num6a SL-17-0651 8 Wnpg W.Case No: C.NOTE: Thirform is furnished to give you a statement ofactual settlement costs.Amounts paid to 1 and by the settlement agent are shawn Items marked (poc)were paid outside the clos�X. They are shown here for informational purposes a_nd a_re not intruded ur the ror,lk. _ Mark Schwartz,Trustee of the 211 Beach Land Trust D.Borrower. 88 Wood Rose Court ' West Palm Beach,Florida 33411 Boca Real Estate Group,LLC,a Florida limited liability company,Trustee of the 211 Beach Avenue Land E.Seller: Trust under agreement dated March 11,2017 7700 Congress Avenue,Suite 3105 Boca Raton,Florida 33487 YSB Investments,LLCF.Lender: 7700 Congress Avenue,Suite 3105 Boca Raton,Florida 33487 211 Beach Avenue G.Property: Port St.Lucie,St.Lucie County,Florida 34952 P Lot 16,Block 4,RIVER PARK UNIT 1,according to the Plat thereof,as recorded in Plat Book 10,at Page 69, of the Public Records.of St:Lucie County,Florida H.Settlement Agent: Liberty Title Company of America,Inc. Place of Settlement: 1844 SE Port St.Ltrcie Blvd,-.Port.Str Lucie,Florida 34952 St.Lucie County I.Settlement Date: September 25,2017 J. ^'T Summary of Borrower's Transaction�T IG Summary of Seller's Transaction I i 100.Gross Amount Due From Borrower: �400.Gross Amount Due To Seller. 101. Contract Sales Price 1021560.001. 401. Contract Sales Price 192 5_0.0:00 102. Personal Property ( 402.-Personal P_ro_perty 103. Settlement Charges to Borrower(line 1400) _ 8,621.191 403. - Adjustments for Items Paid by Seller in Advance:T 4 Adjutme snts for Items Paid by Seller in Advance: 106. City/Town Taxes __ '`4 4U6.'City Town Taxes _ 107. County/Parish Taxes 407. County%Parish Taxes 108. Assessments ' 408. Assessments Non-Advaloretn Assessments Sep 25.2017 thru Y Non-Advalorem Assessments Sep 25,2017 thru 109. "V 4.46 r 409. 4.46 _ Sep 30,2017 Sep 30,2017 120. Gross Amount Due from Borrower. __ 111,125.65_420. Gross Amount Due to Seller: 102,504.46 200. Amounts Paid by or-in Beha_ff of Borrower. _ 300. Reductions 1n Amount Due-to Seller. _ �1. 'Deposit/Earn on ay - - _� 5.000.00 501 EacessDeposit(see"instructions) " 202. Principal Amount of New Loan 95.000.00 i 5E SculemenyC.hareesto Seller(Line 1400) 807.50 203. Existing Loan(s) " ? 503: Existing Loari(s).-'---- 204. 504 Payoff of First Mortgage to YSB Investments, 95,725.75 i LLC 205.. SOS. .P-.awffof Second tuiorlgae" 206. _ - 506. Purchase tMondyrMortgage Adjustments for Items Unpaid by Seller: Adjustments for Items Unpaid by Seller: 210. City/Town Taxes i 510. City/Town Taxes County/Parish Taxes Jan 1,2017 thru Sep 24, - ! County/Parish Taxes]an 1,2017 thru*Sep 24, 211. 2017 951.70` 511. 2017 951.70 212. Assessments 512. Assessments'-_ Total Reductions in Amount Due 2200Total Paid by/for Borrower: 100,951.70:520. - 97,484.95 Seller. 300. Cash at Settlement from/to Borrower: _- �600. Cash at Settlement to/from Seller: 301. Gross Amount due from Borrower(line 120) _T 1.1 i h5 65 601. Gross Amount due to Seller(line 420) 102,504.46 302. Less Amount Paid bylror Borrower(hne 226) 100 951 70. 602. Less Reductions Amount due Seller.(line 520) 97,484.95 303. Cash From Borrower: $10,173.95 603. Cash To Seller: - $5,019.51 II I HUD-1 May 2007 Settement Date:September25,2017 • ! File Number.SL-17-0651 Settlement Charges - 700. Total Sales/Broker's Commission: _ -Paid from i Paid from Borrower's Seller's j Division of Commission as'follows Funds at i Funds at 701. _- -_ -- - -=_ - I Settlement Settlement 702. 703. Commission Paid at Settlement 704. Additional brokerage fee _ 705: Additional brokerage fee 800. Items Payable in Connection with Loan: - 801. Loan,Origination Fee _ 802. Loan Discount to Lex IloldinSs LLC _- - 2.850.00 803. .Appraisal Fee - 804...Credit Report ---- 805. Lenders Inspection Fee to Lex Heldin'gs;LLC _- �- 250:00 -_ 806. Administration Fee to Lax Holdings,LLC -350:00 - 807. Underwriting Fee �- 808. Broker Fee --- --�`--`-- _-� 809. Yield spread premium 810. Procesing Fee 811. Tax service fee J 812. Flood certification fee -__---- - 813. Doc Prep Fee to Schillian and Watarz -- - - 500.001 _ - 814. Wire Fee to YSB Investments,LLC - 50.00 900. Items.Required blender to be Paid in Advance: u TM _ 901.. Dail interestcharge from Sep 25,2017.to Oct L 2017 rig_8--6,30.1 /da_y W YSB Investments.LLC ` -- 190.02; _. _. -- 902. Mortgage Insurance.Premium ' 903. Hazard Insurance Premium _904. Flood Insurance Premium _ '- ------ - .-.-__-.- ---- 1000. Reserves Deposited with Lender: 1001. Hazard Insurance-. -- 1002Mortgageinserance - 1003. City Property Taxes -^' ----- `- - -- - 1004: County Property Taxes 1005. Annual Assessments 1100. Title Cbar�es -- --- -- 1101. SettIement or Closing Fee to'Libert Title Company of America.Inc. 595.00 1102. Abstract and fnle.Related Search Services to Ubero,Title Company of America,Inc. ; .., 125.00 j 1.101 Settlement or Closing Fee. 1104. Courier.Service Fee to Liberty TWe Company of America,inc, -_ _ 50.00: 50:00 1105. Title Insurance.SumhamcFee I 1106. Notary Vi ; - 1107. Attorney Fees _. _ _ _ (includes above item numbers: 1108. Title Insurance to Liberty Title Company of America,Inc. -^ 837.50'. (includes above item numbers: 1109. Lenders Coverage 95.000.00 Risk Rate Premium: - Premium• Risk Rate - i I I0. Ownees Coverage 102,500.00 Premium: $587.50 1111. Endorsement 8.1 to Liberty Title Company of America,Inc.. 25.00 _ 1112. Endorsement FL Form 9 to Liberty Title Com many of America,Inc. 83.75 1200. Government Recordi!�g and:Transfer Charges: - 1201. Recording Fees: Deed --0 1 20.00 ,biTT�rteaee „,137.50 . Releases 20.001 157.50 i .. - .. ,20.00 1202. City/County Tax/Stamps: - Deed 0.00 Mortgage 0.00 i 1 1203. State Tax/Stamps: Deed 717.50 Mtgage or 332.50 i 332.501 717.50 1204. Intangible Tax to Clerk of Court - _ 190.00 1205. Record Trust Affidavits to Clerk of Court _ 1 _ 52.501 20.00 1206. Recording to Clerk of Court 1300.Additional Settlement Changes: 1 --1301. Survey i 1302. Lien search fee to Liberty Title Company of America,Inc. 195.00 i _ 1303. Waste Assessment- - 1304. Utility Assessment 1305. Wire service fee to Libzrty Title Company of America,Inc.- _ ! 50.001 _ 1306. 2016 property taxes to St.Lucie County Tax Collector(poc$449.14 by Seller) "- 1307. 2017 pro to St.Lucie County Tax Collector i 1,737.421 1308. -- -. _--. 1309. ; i 1310. -- 1311_ 1 1400. Total Settlement Charges(Enter on line 103,Section J and line 502,Section K) -''- $8,621.19 I $80750 i i .7�r HUD-1 May 2007 Settlement DatmSeptember 25,2017 0 File Number.SL-17-0651 A. U.S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT Liberty Title Company of America,Inc.. 1844 SE Port St.Lucie Blvd Port St Lucie,Florida 34952 772-335-7474 fare 772-335-7373 i I have carefielly reviewed the HUD-1 Settlement Statement and to the best ofmy knowledge and belief,it is a tree and acemate statement of all receipts and disbursements made an my account or by me in this transaction.I further certify that I have received a copy of HUD-1 Settlement Statement. Boca Real Estate Group,LLC,a Florida limited liability Borrows. Seller. company,Trustee of the 211 Beach Avenue Land Trust under Mark Schwartz,Trustee of the 211 Beach lead Trust agree I I have reviewed the Closing Disclosure,the settlement statement,the lcuder's closing instructions and any and all other forms relative to the escrow fiords,including any disclosure of the Florida title insurance premiums being paid,and I agree to disburse the escrow fiords in accordance with the terms of this transaction and Florida law. Settlement Agent Date: September 25,2017 Jessica L.Corley WARN NG: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 fore and imprisonment For details see Title 18 U.S.Code Section 1001 and Section 1010. i ^ it it i I I i it I i' HUD-1 May 2007