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
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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.