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EL-17-859 Aug 2417 05:29p Debbie 00000 p,5 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL {1�� Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-288374 Permit Number. EL-3-17-859 Scheduled Inspection Date:August 24,2017n� Permit Type: Electrical- Residential Inspector: ir�E/U, P&L, Inspection Type: Final Owner. CLIFFORD, DEBORAH A Work Classification: Alteration Job Address:300 NE 101 Street Miami Shores, FL Phone Number (305)335-6685 Project: <NONE> Parcel Number 1132060135330 Contractor: MOODY ELECTRIC INC Phone: (305)758-2000 Building Department Comments KITCHEN UPGRADE NEW RECEPTACLES& Infractlo Passed Comments APPLIANCES INSPECTOR COMMENTS False E �� Inspector Comments Passed �� Failed El Correction (deeded Re-Inspection a Fee No Additlonal Inspections can be scheduled until re-inspection fee is paid August 23,2017 For Inspections please call:(305)762-4949 Page 12 of 23 Permit, E Miami Shores Village POfmit'ripe.,.Elootr)4Da .-Reslde'ltia) 10050 N.E.2nd Avenue NE . en,rrcrkirca>=ir�n.Altera tion "' Miami Shores,FL 33138-0000 Phone: (305)795-2204 Permit Status:APPROVED fiLOR'NQ' �, 3. ., .. 41�5/2{i17 Expiration: 10/22/2017 tssue�ata Project Address Parcel Number Applicant 300 NE 101 Street 1132060135330 CLIFFS ON THIRD AVENUE LLC Miami Shores, FL Block: Lot: Owner Information Address _Phone Cell CLIFFS ON THIRD AVENUE LLC 1490 NE 103 Street (305)335-6685 4 MIAMI SHORES FL 33138- 1490 NE 103 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 2,400.00 MOODY ELECTRIC INC (305)758-2000 Total SQ Feet: p Type of Work:KITCHEN UPGRADE NEW RECEPTACLES&A Available Inspections: Additional Info:KITCHEN UPGRADE NEW RECEPTACLES&A Inspection Type: Classification:Residential Review Electrical Scanning:1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice# EL-3-17-63492 DBPR Fee $2.25 04/25/2017 Check#:1054 $ 117.30 $50.00 DCA Fee $2.25 Education Surcharge $0.60 03/29/2017 Check* 1015 $50.00 $0.00 Notary Fee $5.00 Permit Fee-Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $2.40 Total: $167.30 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. April 25, 2017 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy April 25,2017 1 ��' c-f � r1 �' � AFD Q� -R-6� N Cu �� 2� ��.� 5 �=�5 c�u � � ��� 3 �s oo Li Miami Shores Village MA 9 2017 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 5t FBC 20 It BUILDING Master Permit No. PC S PERMIT APPLICATION Sub Permit No. F�L 00 51 ❑BUILDING XELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL F-IPLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF CANCELLATION ❑ SHOP p Q CONTRACTOR DRAWINGS =ADDRESS: City: Miami Shores/_ County: Miami Dade zip: l Folio/Parcel#: � — 300(0 013- 5 33® Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER.Name(Fee Simple Titleholder): —S Ott 1-41(2 b PN efl+ f, Phone#: Address: �ss/�: 1 V rfCy��7 X16 � City: H 1 6 3q', X`5 State: y Zip: 331 Tenant/Lessee Name: `i n� ,, nL Phone#: Email: '—` `�6,� K-0 pyo? q U ,Lo CONTRACTOR:Company Name: Phone#: .�S7S8��o19 - Address: City: 44 GtJd0 State: �LZip: Qualifier Name: ewaale z Phone#: State Certification or Registration#: ��'�' l/9�J Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: + O D Square/Linear Footage of Work: Type of Work: ❑ Addition 0 Alteration [:]'New - _ S ❑ Repair/Replace EJ Demolition Description of Work: g&Ae4 t 4M � /Udiw aea.� - Ne Specify color of color thru tile: Submittal Fee$ Permit Fee$ AdeZ5 CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 1.(-1' 30 (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 Anapproved at a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose prt to attachment certified copy of the recorded notice of commencement must be posted at the job site for the fwhich occurs even (7) ys after the building permit is issued. In the absence of such posted notice, the inspectioand a einspection ee will be charg d. SignatSignatur(f:::�� OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before his The foregoing instrument was acknowledged before me this day of 20 by 231h day of Ml\rch .20 S: by 4:11rL4'J CLA 6&pr nally known to john ,J . M WAA who is personally know me or who has produced Cc— cy2t4/U 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: a��`e�atte� uLEN���iii .4 r Sign: .@ . 'QOM �'•ss'/ �i Sign: Print: `o:- ` � .� Print: 4 Ll N Ory VOW Of ��• a oft Seal: FF9 x. _ Seal: •'Q RetlecaMunoz -&•t2% SAjs' c9; ` o My Commission FF 918344 mC \ Expires 09/08/2019 .... APPROVED BY °� / 1 �/C Zl1W/,Z ns Examiner Zoning Structural Review Clerk (Revised02/24/2014) a Electronic Articles of Organization FILED Ll 0008 00 13 AM For May 12 2015 Florida Limited Liability Company Sec. Of State smmason Article I The name of the Limited Liability Company is: CLIFFS ON THIRD AVENUE, LLC Article II The street address of the principal office of the Limited Liability Company is: 1490 NE 103RD STREET MIAMI SHORES, FL. 33138 The mailing address of the Limited Liability Company is: 1490 NE 103RD STREET MIAMI SHORES, FL. 33138 Article III The name and Florida street address of the registered agent is: DEBORAH A CLIFFORD 1490 NE 103RD STREET MIAMI SHORES, FL. 33138 Having been named as registered agent and to accept service of process for the above stated limited liability company at the place designated in this certificate, I hereby accept the appointment as registered agent and agree to act in this capacity. I fixrther agree to comply with the provisions of all statutes relating to the proper and complete perforniance of my duties, and I am familiar with and accept the obligations of my position as registered agent. Registered Agent Signature: DEBORAH A CLIFFORD r 1 Article IV L15000084313 The name and address of person(s) authorized to manage LLC: FILED 8:00 AM May 12 2015 Title: AMBR Sec. Of State ;DEBORAH A CLIFFORD smmason 1490 NE 103RD STREET MIAMI SHORES, FL. 33138 Title: AMBR STEPHEN J CLIFFORD -1490 NE 103RD STREET MIAMI SHORES, FL. 33138 Signature of member or an authorized representative Electronic Signature:,DEBORAH A CLIFFORD " I am the member or authorized representative submitting these Articles of Organization and affirm that the facts stated herein are true. I am aware that false information submitted in a document to the Department of State constitutes a third degree felony as provided for in s.817.155, F.S. I understand the requirement to file an annual report between January 1 st and May 1 st in the calendar year following formation of the LLC and every year thereafter to maintain "active" staters.