PL-17-2616•
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Permit NO. PL -11-17-2616
Permit Type: Plumbing - Residential
WarkClassification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 11/6/2017
Expiration: 05/05/2018
Parcel Number
Applicant
165 NW 96 Street
Miami Shores, FL 33138-0000
1131010250130
Block: Lot:
PROVIDENT FUNDING ASSOCIA
Owner Information
Address
Phone
Cell
PROVIDENT FUNDING ASSOCIATES L P165 NW 96 Street
MIAMI SHORES FL 33150-
165 NW 96 Street
MIAMI SHORES FL 33150-
Contractor(s)
MPS OF MIAMI INC
Phone CeII Phone
(305)627-0199 (786)256-4690
Valuation:
Total Sq Feet:
$ 650.00
0
Type of Work: INSTALL KITCHEN SINK & REPLACE TUB
Type of Piping:
Additional Info: INSTALL KITCHEN SINK & REPLACE TUB
Bond Return :
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$2.25
$2.00
$0.20
$150.00
$3.00
$0.80
$158.85
Pay Date Pay Type
Invoice # PL -11-17-65539
11/06/2017 Check #: 9612 $ 108.85 $ 50.00
11/02/2017 Check #: 9599 $ 50.00 $ 0.00
Amt Paid Amt Due
Available Inspections:
Inspection Type:
Top Out
Final
Review Plumbing
Underground
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.
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
November 06, 2017
Date
November 06, 2017 1
\/Corc-k\-e ( -N6) 02-q- — Lr7-1
/A.
BUILDING
PERMIT APPLICATION
BUILDING ❑ ELECTRIC
PLUMBING ❑ MECHANICAL
JOB ADDRESS: 165 NW 96th Street
City:
Miami Shores Village
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
1-ZIAT,CT ED
NOV 022017
sth
FBC 20 `9
Master Permit No. PL 1 1 "210<6
Sub Permit No.
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Miami Shores County:
Miami Dade
Zip:
Folio/Parcel#:11-3101-025-0130
Occupancy Type:
Is the Building Historically Designated: Yes
Load: Construction Type: Flood Zone:
OWNER: Name (Fee Simple Titleholder): Provident Funding Associates, L.P.
Address: 851 Traeger Avenue
BFE:
NO
FFE:
Phone#: 650-652-1300
City: San BrunoState: CA
Tenant/Lessee Name: n/a
Email: rbrede@provident.com
Phone#:
Zip: 94066
CONTRACTOR: Company Name: av- Gko/N% Vl c-- .
Phone#: 3( 5_ (Dol -1 COCl vl
Address: Ss ‘/••• l) i v�
City: \-\ 1 Q\, )c 1 \A State:(.n
Qualifier Name: 1-1k Ot4 �L f I -4 Cit SS �il )'l F'-1- Phone#:?c �7 � 1 n\0(
State Certification or Registration #: CV- C.14 LD -1 O(D Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ � DSC)- Square/Linear Footage of Work:
Type of Work: ❑ Addition
��❑ Alteration El New IN Repair/Replace ❑ Demolition
Description of Work:',�ti(1 rt I \ �(, 1..-4-0 S� Y� k I �'n e e -I'VI C3
Specify color of color thru tile:
Submittal Fee $ SO -Pa I ! Permit Fee $ /0 CO/CC $
Scanning Fee $ Radon Fee $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
CCF $
DBPR $
(Revised02/24/2014)
TOTAL FEE NOW DUE $ I 0 S • /
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 in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signatur
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of LtAtis.J�j , 20 `---) , by
r6l-E/tC, , who is personally known to
me or who has produced ANod1.--\C/'as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
•
**************
S
J. PHILLIPS
Commission # 2095221
Notary Public - California E
San Mateo County
M Com �=�yQ19.
APPROVED BY
(Revised02/24/2014)
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
-2)0 day of I , 20 �� by
C� \(p 4 (,iS SooNho is personally known to
me or who has produced V ` rLS 1", Q_eirFseps
identification and who did take an oath.
NOTARY PUBLIC:
Sign: //��1' ��
Print: �Ct (Zb\ S V)\ \Q
Seal: ( , tY P`e MARBIS PONCE
i9.1 V� , Notary Public - State of Florida 0
�` . Commission # FF 212217
( % My Comm. Expires Mar 22.2019
+ * ' O+'**Vended teoeettNallendiNestwAsen. L********
1 r ----o---..--..--...--41
******************
Plans Examiner
Structural Review
Zoning
Clerk
This
,Sf Iie ref &thiamin
4Rzzrcl! Avert.$ u
(ecretarri of,*tate
CERTIFICATE OF LIMITED PARTNERSHIP
IMPORTANT—Read instructions on back before completing this form
Certificate Is presented for filing pursuant to Section 15621, California Corporations
Code.
Form LP- )
1. NAME OF LIMITED PARTNERSHIP
Provident Funding Associates, L.P.
2. STREET ADDRESS OF PRINCIPAL EXECUTIVE OFFICE
1050 East Evelyn Avenue
CITY AND STATE
Sunnyvale, CA
ZIP CODE
94086
3. STREET ADDRESS OF CALIFORNIA OFFICE IF EXECUTIVE OFFICE IS IN ANOTHER STATE
CITY
CA
ZIP CODE
4. COMPLETE IF LIMITED PARTNERSHIP WAS FORMED PRIOR TO JULY I. 1984
AND
IS
IN EXISTENCE
ON DATE THIS CERTIFICATE IS EXECUTED.
THE ORIGINAL LIMITED PARTNERSHIP CERTIFICATE WAS RECORDED ON 19
WITH THE
RECORDER OF COUNTY. FILE OR RECORDATION NUMBER
S. NAMES AND ADDRESSES OF ALL GENERAL PARTNERS: (CONTINUE ON
A. NAME: Provident Funding Group, Inc.
ADDRESS: 1050 East Evelyn Avenue
CITY: Sunnyvale STATE. CA ZIP CODE: 94086
SECOND PAGE. IF NECESSARY)
C. NAME:
ADDRESS:
CITY:
STATE:
ZIP CODE:
B. NAME:
ADDRESS:
CITY: STATE: ZIP CODE:
D. NAME:
ADDRESS:
CITY:
STATE: ZIP CODE:
8. NAME AND ADDRF�R OF AGENT FOR SERVICE OF PROCESS:
NAME
Ralph A. Pica
ADDRESS: 1050 East Evelyn Avenue
crry: Sunnyvale
STATE: CA ZIP co0E:94086
7. ANY OTHER MATTERS TO BE INCLUDED IN THIS CERTIFICATE MAY
BE NOTED ON SEPARATE PAGES AND BY REFERENCE HEREIN ARE
A PART OF THIS CERTIFICATE.
NUMBER OF PAGES ATTACHED:
0
44,
8. INDICATE THE NUMBER OF GENERAL PARTNERS SIGNATURES
REQUIRED FOR FILING CERTIFICATES OF AMENDMENT.
•i•.QL TION. CONTINUATION AND CANCELLATION.
A
0
w
OF GENERAL PARTNERS) SIGNATURE(S) 1S/ARE:
9. IT IS HEREBY DECLARED THAT) AM (WE ARE) THE PERSONS) WHO EXECUTED THIS CERTIFICATE
OF LIMITED PARTNERSHIP WHICH EXECUTION IS MY LOUR) ACT AND DEED. (SEE INSTRUCTIONS)
Provident Fung Gro „Inc.
.
President 11/6/92
By:ie
SIGNATURE
POSITION OR TITLE
DATE•
SIGNATURE
POSITION OR TITLE
SIGNATURE
POSITION OR TITLE
GATE
SIGNATURE
DATE POSITION OR TITLE
DATE
10. RETURN ACKNOWLEDGEMENT TO:
NAME
ADDRESS Steven K. Denebeim, Esq.
Feldman, Waldman & Kline, APC
235 Montgomery St., #2700
Z(PcoaeI San Francisco, CA 94104-3160
CITY
STATE
5961.0000
SEC/STATE REV I SS
FORM IF -i— LUNG FEE. )70
Approved by Soctetary of Sure
1
(PLEASE INDICATE NUMBER ONLY
THIS SPACE FOR FIUNG OFFICER USE
FILED
M ))>Q otfre:, of the S.crwu,ly of Stott
a( tM Seat -v.4 C.Momio
'' NOV 10119:?
MAP.CH FONG EL)
SECRETARY OF SATE
TLORIDA DEPARTMENT O STATE
DIVISION OF CORI'oRfl IONS
DIVISION of
CORPORATIONS
an o�ciiri Stene.of Florida ti ebsite
gQpartment of State / Drvislon of Corporation / Search Records / Detail By Document Number /
Detail by Entity Name
Foreign Profit Corporation
PFG LOANS, INC.
Cross Reference Name
PROVIDENT FUNDING GROUP, INC.
Filing Information
Document Number F98000004548
FEI/EIN Number 77-029374q,
Date Filed 07/30/1998
State CA
Status ACTIVE
Last Event CANCEL ADM DISS/REV
Event Date Flied 10/27/2008
Event Effective Date NONE
Principal Address
851 TRAEGER AVENUE
SUITE 100
SAN BRUNO, CA 94066
Changed: 02/21/2012
Mailing Address
851 TRAEGER AVENUE
SUITE 100
SAN BRUNO, CA 94066
Changed: 02/21/2012
EegjsteredAgent Name & Address
CORPORATION SERVICE COMPANY
1201 HAYS STREET
TALLAHASSEE, FL 32301-2525
Officer/Director Detail
Name & Address
Title PDVC
http://search.sunbiz.org/InquiryfCorporationSearch;SearchResu...ding&IistNamoOrder=PROVIDENTFUNDING%20F990000022710 10/25/17, 2:43 Pit
Page 1 of 3
PICA, R. CRAIG
. 851 TRAEGER AVENUE, SUITE 100
SAN BRUNO, CA 94066
Title DSVP
PICA, DOUGLAS
851 TRAEGER AVENUE, SUITE 100
SAN BRUNO, CA 94066
Title DSVS
BLAKE, MICHELLE
851 TRAEGER AVENUE, SUITE 100
SAN BRUNO, CA 94066
Annual Reports
Report Year Filed Date
2015 04/13/2015
2016 04/29/2016
2017 04/24/2017
Document Imagel
04/24/2017 -- ANNUAL REPORT View image n PDF format I
04/29/2016 -- ANNUAL REPORT View image in PDF format J
04/13/2015 -- ANNUAL REPO T
05/01/2014 -- ANNUAL REPORT
04/16/2013 -- ANNUAL REPORT
02/21/2012 -- ANNUAL REPORT
04/04/2011 -- ANNUAL REPORT
04/21/2010 -- ANNUAL REPORT
04/24/2009 -- ANNUAL REPORT
10/27/2008 -- REINSTATEMENT
04/30/2007 -- ANNUAL REPORT
04/24/2006 -- ANNUAL REPORT
94/06/2005 -- ANNUAL RFPORT
02/17/2003 -- ANNUAL REPORT
05/29/2002 -- ANNUAL RF -PORT
09/06/2001 -- ANNUAL REPORT
05/08/2000 -- ANNUAL REPORT
97/30/1999 -- ANNUAL REPORT
07/30/1M -- Fgrgigr Pr it
View image h PDF format
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J
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Page 2 of 3
•
• ■ • • ■ • , .. L. L. \. _ • ■
DOCUMENT# F98000004548
Entity Name: PFG LOANS, INC.
Current Principal Place of Business:
851 TRAEGER AVENUE
SUITE 100
SAN BRUNO, CA 94066
Current Mailing Address:
851 TRAEGER AVENUE
SUITE 100
SAN BRUNO, CA 94066
FEI Number: 77-0293745
Name and Address of Current Registered Agent:
CORPORATION SERVICE COMPANY
1201 HAYS STREET
TALLAHASSEE, FL 32301-2525 US
FILED
Apr 24, 2017
Secretary of State
CC5588344593
Certificate of Status Desired: No
The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida.
SIGNATURE:
Electronic Signature of Registered Agent
Officer/Director Detail :
Title PDVC Title DSVP
Name PICA, R. CRAIG Name PICA, DOUGLAS
Address 851 TRAEGER AVENUE, SUITE 100 Address 851 TRAEGER AVENUE, SUITE 100
City -State -Zip: SAN BRUNO CA 94066 City -State -Zip: SAN BRUNO CA 94068
Title DSVS
Name BLAKE, MICHELLE
Address 851 TRAEGER AVENUE, SUITE 100
City -State -Zip: SAN BRUNO CA 94066
Date
I hereby oanay that me Information lndloatad on tms report or supplemental report is true and ec0urate and that my electronic signature shall have the same 1ega1 effect as if made under
oath; that 1 am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 607, Ronda Statutes; and that my name appears
above, or on an attachment with all other Ake empowered.
SIGNATURE: MICHELLE C. BLAKE
SECRETARY 04/24/2017
Electronic Signature of Signing Officer/Director Detail Date
Corporate Resolution
I, Michelle C. Blake, Secretary of Provident Funding Group, Inc., a corporation duly organized
and existing under the laws of the State of California, and General Partner of Provident Funding
Associates, L.P., do hereby certify that the following is a true and correct copy of a resolution of
the Board of Directors of said corporation, adopted at a special meeting held on the 6th day of
January in the year 2016:
RESOLVED, that any one of the following:
• Ernest Brede, Assistant Vice President
• Rebecca Brede, Assistant Vice President
• Milin Patel, Assistant Vice President
is authorized and directed to cause the Company to take all steps necessary to effect the sale of
any real property pursuant to a notice of time and place of a foreclosure sale; to bargain, sell,
transfer, assign, set over and deliver the real property; and to sign the name of Provident
Funding Associates, L.P., to all deeds, contracts of sale or other instruments necessary to carry
out this resolution, all of the acts in the premises undertaken by each of these individuals being
ratified as the act and deed of this corporation.
FURTHER RESOLVED, that any and all actions taken these individuals in connection with the
matters contemplated by this resolution be, and are hereby, approved, ratified and confirmed
in all respects as full as if such actions had been presented to the Board of Directors for its
approval prior to such actions being taken.
Dated: 1/28/16
fivelAtiladQ1L,
Michelle C. Blake, Secretary
PF Property Management
851 Traeger Avenue, Suite 100
San Bruno, California 94066
Telephone: 650-652-1300 ext. 3212/Facsimile: 650-652-1348
October 30, 2017
Miami Shores Village Building Department
10050 N.E. 2nd Avenue
Miami Shores, FL 33138
RE: 165 NW 96th Street, Miami Shores, FL
Dear Sir / Madam -
The purpose of this letter is to confirm Provident Funding Associates, L.P.,
Provident Funding Group, Inc. and Provident Funding Property Management
are all part of the same group.
If you have any questions, please contact me at 408-694-1735 Ext. 7157
Thank you for your assistance.
Respectfully,
Ernie Brede, Manager
PF Property Management
Provident Funding Associates, L.P.
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