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RC-17-858 (2) Permit NO. RC- -� - � �eK°' Lei PoImIt Miami Shores Village 7",y+"p8'Residential Cot18tmction 10050 N.E.2nd Avenue NE 14/ctrk Cj sssificatlon:Alteration Perl I 'It Miami Shores,FL 33138-0000 Petrrii Status Phone: (305)795-2204 APPROVED . u2512017 Expiration: 10/22/2017 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 MIAMI SHORES FL 33138- - 1490 NE 103 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: m $ 15,050.00~MYM DILBERT ENTERPRISES, INC 786/256-6434 (305)945-0727 _., Total Sq Feet: 150 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Final PE Certification Date Denied: Window Door Attachment Type of Construction:CHANGE OUT OLD KITCHEN CABI Occupancy: Framing Stories: Exterior: Insulation Front Setback: Rear Setback: Drywall Screw Left Setback: Right Setback: Fill Cells Columns Bedrooms: Bathrooms: Window and Door Buck Plans Submitted: Certificate Status: Review Planning Certificate Date: Additional Info:CHANGE OUT OLD KITCHEN CABIf Review Building Review Electrical Bond Return: Classification:Residential Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Structural CCF $9.60 Review Mechanical Invoice# RC-3-17-63491 DBPR Fee $6.77 03/29/2017 Check#:1015 $50.00 $454.64 DCA Fee $6.77 Education Surcharge $3.20 04/25/2017 Check#:1054 $454.64 $0.00 Notary Fee $5.00 Permit Fee $451.50 Scanning Fee $9.00 Technology Fee $12.80 Total: $504.64 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 pert ' reto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In ac pting thi permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are r quired for E CTRICAL,PLU BING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. WNERS AF IDAVIT: I certi hat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating onstructi n t ore,I authorize the above-named contractor to do the work stated. April 25, 2017 orize Si nature:Owner / Applicant / Contractor / Agent Date Building epartment Copy April 25,2017 1 Q Miami Shores J Village MA R ;201Buildin Department . 7 � ` 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 H Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 CJ't k FBC 2014 BUILDING Master Permit No.�zC PERMIT APPLICATION Sub Permit No. �UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP AA// CONTRACTOR DRAWINGS JOB ADDRESS: '. wv /y� SOI !'?z City: Miami Shores / Coun : Miami Dade Zi : Folio/Parcel#: /( ®�'— �` �Q the Building Historically Designated:Yes NO Occupancy Type:P=65-- ,Load: Construction Type: Flood Zone: BF,E:: FFE: OWNER* Nam "(F a Simple itl holder) lfvf Irl'r� hone Address: City. H, ��\ State: Zip: Tenant/Lessee Name: Phone#: Email: ,/ CONTRACTOR:Company Name:7�/ �� �/?��9�/'/.S-e lCI Phone#:�-O cT� 6 y3�1 Address:2j/a o City: ,� QS /��r,� State: f"LL Zip: .�. Qualifier Name: Az`P � i� 1`4 a✓T Phone#:� � State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State:, Zip: Value of Work for this Permit:$ e/Jj'4a�d Square/Linear Footage of Work: rt SO Type of Work: ❑ Additio ❑ Alteration ❑ New ®'repair/Replace EJ Demolition Description of Work: ® / l6s�2 i G Specify color of color thru tile: Submittal Fee$ '50 tm Permit Fee$ T5� �® CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ V W Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 5-5 4 (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 i suance of a building permit with an estimated value exceeding$2500, the applicant must promise m ood faith that a copy o, a notic of commencement and construction lien law brochure will be delivered to the person whose pr rty is subject to attac ent. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the irs in pection which oc urs seven (7) ays after the building permit is issued. in the absence of such posted notice, the inspe ' n w* of be proved d a reinspect on fee will be ch rged. Signa ure Signatur OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 1145y day of 20 1� n'✓by IS day of CwA ,20 1-7by S�I[�1'H F"\ CLI C— w o is personally known to A aN 4Ac- DtLl who is personally known to me or who has produced Flr 0J s as me or who has produced V:�7L, , as identification and who did take an oath. identification and who did take an oath. �O;tilllllllll/// NOTARY PUBLIC: NOTARY PUBLIC: `\`\v�� •y0/��,,�i \01N11111111////� .�Q�PES• �'�- /, • •oma_ Sign: ••..... �pyo Sign: = �� 8, a :r= •�!.`' to: Print: �Q y���•J' Print =�1 0 m Seal: ��;z N .a Seal: sdb •.•417 • QJ�e i tis���o0 AW .•'Oho: Oss�rr///llllllll W eN of Cti�� APPROVED BY Y s ° Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) CTQB Construction Trades uaiifying Board 'BUSINESS CERTIFICATE OF COMPETENCY f. 05BS00635 DILBERT ENTERPRISES INC DILBERT ARNICK A Is certified under the provisions of Chapter 10 of Miami-Dada CopMy >.:.,. • C 0053 QU'4LIFYIN ,TP-4DE(S) 0099 FINISH CARPENTRY GYPSUM DRYWALL FINISH Juliana H,Saias P.E Settetary of the Boartl Miami-page Courgy retai ", Mv,•r+�Y7 aU property rights herein. VWAwww miamitlatle .gov/economy J AC40 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYY1) 3/13/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Pierina Campozano Jackson Insurance Agency PHONE (305)824-3464 No (305)822-8535 2075 West 76th St ADDDRE33:gcampozano@jacksonagency.com INSURER(S)AFFORDING COVERAGE NAIL S Hialeah FL 33016 INSURER ARockin ham Casualty Company 13683 INSURED INSURER B: Dilbert Enterprise Inc. INSURER C: 2088 SW 57th Avenue INSURER 0: INSURER E: West Park FL 33023 INSURER F: COVERAGES CERTIFICATE NUMBER:2017-2018 GL COI REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AWL TYPE OF INSURANCE B POLICY NUMBER MO Y EFF POLICY EXP LIMITS LTRX COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO 50,000 A CLAIMS MADE OCCUR PREMISES occurrence $ RFLA201981-00 2/27/2017 2/27/2018 MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X JF-1LOC PRODUCTS $ 2,000,000 POLICY nET OTHER: $ AUTOMOBILE LIABILITY C a aBINED NG LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ ACOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Par cddertt S UMBRELLA UAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION STATUTE ER $ WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLO $ Ifdescribe under ES DCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remark®Schedule,may be attached If more space Is required) This certificate is solely for the use as " Evidence of Insurance" License No. 05BS00635 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Building Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE Ed Jackson/PCAMP ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(muni TE *A�® CERTIFICATE OF LIABILITY INSURANCE DA 3/14/201m7rn THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorseme s. PRODUCER SUNZ Insurance Solutions, LLC. ID: (TLR) NAME`� WorkersComp Department c%TLR of Bonita, Inc PHONE FAX 700 Central Ave,Suite 500 E Mai 727-520-7676 x 3 C No): 727-525-3862 St.Petersburg, FL 33701 ADDRESS: corts0encorehr.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: SUNZ Insurance Company 34762 INSURED INSURER 13: TLR of Bonita, Inc EnterpriseHR INSURER C: 700 Central Avenue Suite 500 INSURER 0: St. Petersburg FL 33701 INSURER E: INSURER!F COVERAGES CERTIFICATE NUMBER: 34637168 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL R POLICY POLICY NUMBER nMD EFF POLICY EXP LIMITS LTR COMMERCIAL GENERAL LIUBILr1Y EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE EIOCCUR PREMISES occrmence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEML AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ POLICY El JEST LOC PRODUCTS-COMP/OPAGG $ OTHER $ AUTOMOBILE LIAMLITY OMBBIINED ED SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per acddent) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per acddeM UMBRELLA UAS HOCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTON $ A WORKERS COMPENSATION WCPE0000000112 6/1/2016 6/1/2017 ,i STATUTE ER AND EMPLOYERS LIABILITY YIN ANYPROPRIETOR/PARTNERIEXECUTNE -1 N /A E.L.EACH ACCIDENT $ 1,000,000.00 OFFICER/MEMBEREXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1 000 000.00 I yes.describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Addttional Remarks Schedule,maybe attached H more space Is required) Coverage Provided for all leased employees but not subcontractors of:Dilbert Enterprises Inc Client Effective:1/18/2017 05BS00635 finish carpentry,gypsum drywall finish CERTIFICATE HOLDER CANCELLATION 1961 Miami Shores Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 9 P THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores FL 33138 AUTHOR®REPRESENTATME Glen J Distefano ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 39637168 1 Master Certificate I Andrea Delucchi 1 3/19/2017 9:05:96 AM (CDT) I Page 1 of 1 Local Busi ness Tax Pecei pt Miami-Dade County, State of Florida -THIS ISNOT ABILL-DO NOT PAY OT 7221927 BUSINESS N.AM E/LOCATION RECEIPT NO. EXPIRES DILBERT ENTERPRISES INC NEW BUSINESS SEPTEMBER 30, 2017 DOING BUSINESS IN DADE 7506350 Must be displayed at place of business COUNTY Pursuant to County Code Chapter BA-Art.9&10 OWNER SEC.TYPE OF BUSINESS PAYM ENT RECEIVED DILBERT ENTERPRISES INC 196 SPECIALTY BUILDING BY TAX COLLECTOR CONTRACTOR 75.00 03/14/2017 Worker(s) 1 OSBS00635 0202-17-002646 This Local Business Tax Receipt orgy con"rms payment of the Local Business Tax.The RIRCeipt is rota license. pernit,or a cert"cation of the hd dees quai i"cations,to do torsi ness.Holder nest comply with any governrnen or ongovernmsntai regulatory laws and requirementswhich apply to tie mess. The F t Fr NQ above must be displayed on ail commerciai vehicles-Miami-Dade Code Sec as-2M MMSFor more rrdorniatiomwsitwww JiamdadecovltsiYcdleckx i 6/9/2017 8:45:04 AM PST (GMT-8) FROM: 100005-TO: 13057568972 Page: 2 of 2 DATE(MM/DD/YYYY) .Q►C'oR®� CERTIFICATE OF LIABILITY INSURANCE 7x/9/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CN PRODUCER SUNZ Insurance Solutions, LLC. ID: (TLR) NAME Workers'Comp Department c/o TLR of Bonita Inc PHONE 727.520-7676 x 3 N Nol: 727-525-3862 700 Central Ave, quite 500 EMAIL St. Petersburg, FL 33701 ADDRESS: certs encorehr.com INSURERS)AFFORDING COVERAGE NAIC# INSURERA: SUNZ Insurance Company 34762 INSURED INSURER B: TLR of Bonita, Inc EnterpriseH R INSURER C: 700 Central Avenue Suite 500 INSURERD: St. Petersburg FL 33701 INSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER: 36089915 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE DL SUER POLICY NUMBER M°DDI EFF POYYYI LICY EXP YYYl 1JMRs COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS MADE OCCUR PREMISES Me occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ElJPER� LOC PRODUCTS-COMP/OP AGO $ OTHER: AUTOMOBILE LIABILITY COMBINED $ ANY O Ea OWNED accident WNED SCHEDULED BODILY INJURY(Par person) $ O AUTOS ONLY AUTOS BODILY INJURY(Par accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per Pcadent $ UMBRELLA LIABOCCUR EACH OCCURRENCE $ EXCESS LIARHCLAIMS-MADE AGGREGATE $ DED RETENTION $ A WORKERS COMPENSATIONWCPE0000000113 6/1/2017 6/1/2018 PER OTH- AND EMPLOYERS'LIABILRY YIN N ✓ STATUTE ER ANYPROPRIETOR/PARTNER/EXECUrIVE WCPE0000000112 6/1(2016 6/1/2017 OFFICER/MEMBEREXCLUDED7 ❑ NIA E.L.EACH ACCIDENT $ 1,000,000.00 (Mandatory in NH) Ifes E.L.DISEASE-EA EMPLOYEE $ 1,000,000.00 y , DS under IPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more space is required) Coverage Provided for all leased employees but not subcontractors of:Dilbert Enterprises Inc Client Effective:1/18/2017 05BS00635 finish carpentry,gypsum drywall finish CERTIFICATE HOLDER CANCELLATION 1961 Miami Shores Village Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 10050 NE 2nd Avenue THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores FL 33138 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZFDREPRESENTATME Glen J Distefano ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 36089915 Master Certificate- Current 2017 Aimee Gray 6/9/2017 10:43:22 AM (CDT) Page 1 of 1 154 I d�l - — 24 24 24 t38 C� 3� _ I ' 92 • IDO Bad" 111 - -3j4 �\ —--—-— -- - -—- JUF is k3 72 44 PERU VILLAGE �IDC ®ATE APPROVE-1, `. ZONI P 1 . .. . . . . . . . sV • • • • •.• • • TO :.0;,,-UANCE WITH ALL FEDERA-a. {: B r.I,,I xi_ILES ANDD FREL1 �lC�l�1� J 154 —,E 33 —36 9 I 36 • 24 16 30 38 ,a II .z '"6 j+, 0300 10D I' '-------------------------------•------------------- � 29�34_.—�---z 34 r' --------- ----------------------------------------------- I it ' I R3 72 314:__ --- NO Plllo+i' . 2 FEE I'l ALL Fik: NO POINT ALONG COUNTER TO BE MORE THAN ADD SMS" 2 Ftt FgOM G.F.1 PROTECTED RECEPTACLE. PUT D/W RECEPTACLE UNDER SINK. INr-' ALL FIXED APPLIANCES ON DEDICATED CKTS. ADD SMOKE/CARBON MONOXIDE DETECTORS. ANY AND ONDUC IOTH AND RUBBER NSULATED ORS TO BE REPLACED. .. ... . . . . . .. . .. . . . . ... . ELECTRICAL REVIEW APPROVED 1 ATE • ••• •• ••• • . . . . . . . . . . . . . . . . .. . . . . . . . ... . . . ... . ... . . . . ... . . . . . . . . . . . . ... .. . . . .. .. ... . . ... . . r � <r . . . . . ... ... . .. . . . . ... ... . .. ... .. . . . .. . ... . . . . . . . . . . . . . .. . . . . . . . ... . . . ... . ... . . . . ... . . . . . . . . . . . . . .. .. ... . .. .. ... . . ... . . f a •• ••• • • • • • •• • •• • • • • ••• • •• ••• •• • • • •• • ••• •• ••• • • • • • • • • • • • • • •• • • • • • • • ••• • • • ••• • ••• • • • • ••• • • • • • • • • • • • • • •• •• • • • •• •• ••• • • • ••• • • _ _ 7 4-•y .`y 0000•• • • • •••••• - :.0..0 ••••o • • • • ' • • • • • • •s••0e • e 000:60 go. 00000 e• • 0000•0 • o 0000• s•• •• • • • 0000 • •• 0000••• • • • 0000•0000 • 0000•• •• •• 000• 0•• 0000•• Gose • • • • 0000 d f �pb ,JG rv! 554- Electronic Articles of Organization L 8 0LED0AM 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 further agree to comply with the provisions of all statutes relating to the proper and complete performance of my duties, and I am familiar with and accept the obligations of my position as registered agent. Registered Agent Signature: DEBORAH A CLIFFORD 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 affirn 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" status.