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DEMO-11-351 (2)A ' Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 156542 Permit Number: DEMO -3 -11 -351 Scheduled Inspection Date: October 18, 2012 Permit Type: Demolition Inspector: Bruhn, Norman Inspection Type: Final Owner: MEDIA, GILBERTO Work Classification: Building Job Address: 165 NE 98 Street Miami Shores, FL 33138 - Phone Number Parcel Number 1132060132330 Project: <NONE> Contractor: EMERGENCY SERVICES 24 Phone: (561)241 -1227 Building Department Comments DEMO DRYWALL AND CEILING Inspector Comments Passed Failed Correction Needed ❑ Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. October 17, 2012 For Inspections please call: (305)762 -4949 Page 1 of 23 Miami Shores e Villa g Buildin g Department artment 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 C�+ i Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 JAN" 2 2 2014 BUILDING Permit No. PERMIT APPLICA ON Master Permit No. PC I t 0 C� Permit Type. BUILDING R JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: 'A" A Folio/Parcel #: Is the Building Historically Designated: Yes /NO I Flood Zone: OWNER: Name (Fee Simple _ Titleholder): TN1 Phone #: 0AP to A%13,00- Address: ip✓�� T Ale City:1! �i�!' !/7D State:. • Zip: Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Company Name/-fec21 .�/l�t�l.�� .Pl�on #: Address: ,!57ta1 , Le l l City: J1A, State: Qualifier _ fier Name• �3".n ., �-, zip: 33 iJ State Certification or Registration f CZ2::: /;1 67 G�Gj Certificate of Competency #: Contact Phone#: Email Address: B_e-n�_j 0 1 °ems ✓ r,01 , a DESIGNER: Architect/Engineer: Phone #: v Value,of Work for this Permit: $_ Sgoare/Lineai �*ootage 6f Work: Type of Work: ❑Addition L—]Alferation ' ; bkepairlReplace ODemolition ��Tew:r: . Description of Work• '$ s �V -� �: ® Al Submittal Fee $ Permit Fee $_ Scanning Fee $ s C Radon Fee $ _ L1 I 2A>0 CCF $ CO /CC $ DBPR $ Bond $ Notary $ o �� Training/Education Fee $ Technology Fee $ TOTAL FEE NOW DUE $_�� 0® Double Fee $ Structural Review $ Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State zip 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all word will be done in compliance with all applicable laws regulating construction and zoning. y < "WARD TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN 4 YOUR" ' PAYING- � ' TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE REC09DING YOUR NOTICE OF CO NEEA1EW." m, Notice to Applicant; As a condition to the issuance of a building,pernzit with an estimated value exceeding: $250a. -ilte. applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. V, SignaturcC—_.&: 7- ,a,, Signature Owner or Agent The foregoing instrument was acknowledged before me t,hiis� day ofd , 20 4, by tY't WeZU, , who is personally known to me or who has produced AX.& 1 CGI/�S� As identification and who did take an oath. NOTARY PUBLIC: _.. �owledgecd gr8m� st 1e t w before me this_ day of n1 A , 20L, by �;ra who is personally known to me or who has produced -f� 1 LI / 6 2bLIW as identification and who did take an oath. Commission # 1919348 s Notary Public - Calito►cia Sign: 311 San Mateo County Sign �` M Comm. Exillres Jan 25, Print: ..➢. V11�Oa My Commission Expires: c s' 201 My skak��laaksksksk�kskskakakakaksk�sk�kAaskak�Iask�k ' • � 1 C �'}` skakak�Rsk sksIssg�Cak�kak�akakaksl APPROVED BY J /v Jam/ Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) PY PUBLIC: Noaryj Rgbtltc State of Flohaa Feliciano '+A My Commissim FF 3mmigi D$ ► SgxpUes o1 /1 212 01 8 �M Zoning Clerk Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida. 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT Permit N. OifVne l's lVamej (Fee Simple Title Holder) ' U Owner's_ Address. S_°� I i rcx e cr e r v e. Citye roa rl r' Job Address (Of where work is being done):_ City: Miami Shores State: C it State:—Florida Phone t L"51=L62- --13 C r' Zip Code: " Zip Code: 3/ �° ns e. � Contractor's Company Name: , " Vrq Phone #: —3e�S yo Address: cS - 4- / 3 City: _ " 4 d State Zip Code: .3 31 Qualifier's Name . j ' r� ! ,i -4 412 Lic. Number:. e -Ac " 7 fa� Architect/ Engineer of Record Name: Address: City: Describe Work: State: Phone Zip Code: #Z,1A zk- I hereby certify that the work has been abandoned and/or the contractor /architect is unable or unwilling to complete the contract. I hold the Building Official and the Miami Shores harmless for all legal ,-Signature owmerorAgent The foregoing instrument was aknowledged before me this day of Fes' ,2013,by f Who is personally known to me or who has produced G4 D 1'S L-i CO'Ifw- as indentification. Notary Pu Sign: Seal: J. PHILLIPS Commission * 1919343 -+i Notary Public - Ca1HoTnta San Mateo County M Camm. Ex res Jan 25, 2015 Signature C orenoow�ged The foregoing instrument was before me this L­ day of 20/ y Dr"r� ;3 who is personally k wn to me or who has produced S Notary Publi - o . 3 Sign: 4. Seal: USPS.com® - USPS TrackingTM Page 1 of 2 English customer service USPS Mobile Register /Sign In USP'SaIC ~ y Search USPS.com or Track Packages Quick Tools Track Y Enter up to 10 Tracking Wnd Find USPS Locations BuyStamps 1. - -. ._. ..m... __.. _ _.._ ...._.. ___.. ..... Schedule a Pickup ca' ' S Tracking Fi e Customer Service > i - 1 Have qumdogs? We're here to help. Hold Mail Change of Address ' Tracking Number: 70132250000189047405 Expected Delivery Date: December 19, 2013 Product & Tracking Information Available Options Postal Product: Features: Email Updates First -Class MaP Certified Mail's Return Receipt DATE & TIME STA S OF ITEM LOCATION December 21, 2I" , 8:17 ; U 9 Orlgfn Sort WEST PALM am adllty BEACH, FL 33408 3,8:28 Processed at USPS WEST PALM am Origin Sort Facility BEACH, FL 33409 December 19, 2013 , 5:51 Processed at USPS WEST PALM Pin Origin Sort Facility BEACH, FL 33409 December 19, 2013 , 9:27 Undeliverable as BOCA RATON, FL 33487 am Addressed December 19, 2013,12:09 Processed at USPS WEST PALM am Origin Sort Facility BEACH, FL 33416 December 18, 2013 Depart USPS Sort WEST PALM (((I Facility BEACH, FL 33416 Dumber 18, 2013, 1:23 Processed at USPS WEST PALM pm Origin Sort Facility BEACH, FL 33416 i December 17, 2013 Depart USPS Sort Facility MIAMI, FL 33152 December 17,2013,9-38 Processed at USPS MIAMI, FL 33152 i Pm Origin Sort Facility December 17, 2013, 7:29 Dispatched to Sort MIAMI, FL 33184 Pm Facility 1 December 17, 2013 , 10:15 Acceptance MIAMI, FL 33184 am LEGAL ON USPS.COM ON ABOUT.USPS.COM OTHER USPS SITES https:// tools. usps. com /go/TrackConfi - mAction .action?tRef--fullpage &axnp;tLc =1 &amp;tLa... 1/5/2014 Ce,rti f iii Building Contractors COC 1257929 13876 SW 56th St. Suite N9136 Miami, FI 33175 Tel-305 380 -6656 Fax.305 380 -7082 December 14, 2013 Emergency Services 24, Inc. 1021 South Rogers Circle Bay #1 Boca Raton, Fl 33487 Attn: William Pollack CBC057844 Reference: Miami Shores House Folio 11- 3206 -013 -2330 Address: 165 N.E. 98h Street, Mia Shores, Fl 33138 Renovation & Construction Group, Inc. will clear this permit violation within 10 days of this writing unless we receive formal objections to do so Permit # RC11 -108 Permit # RC10 -1935 In order to update this property old permit violations must be renewed and then All Inspections cleared. We will take care of this process if after 10 days we do not receive official word from your company. Sincerely, Tammy Olen Fajardo/ 7 CBC 1257929 New Construction Remodeling Projects Commercial Building Specialists FLORIDA SHORT-FORM State of Florida County of _ Place Notary Sea/ Stamp Above The foregoing instrument was acknowledged or who has produced l- y "'N L1 c a 1i`- Type of Identification as identification. -� SignatuWof Notary Public f � _ Name of Notary Typed, Printed or Stamped Notary Public -- State of Florida ��731(0l►T1 [� Thgrgh this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document Description of Attached Document Title or Type of Document: M, c ` 11 r�) Document date: J2-1 1l 1 Number of Pages: Signer(s) Other Than Named Above: :,t7'. "' d \�> .a s�"'.v�aJ'x�N> a ' A, 2Y :.:i' `. r{�a7L \a.?% d> Nr aY s " °e ' x7" `:t?' m?'Z��??> r7, - rY,>^`ti`,'r .V `ar "'aiq�•7.'Z a,*':`a�?.: a���nr.. `l © # 121 rol F i ej F i i • i a A, OEM* Mi. r ;lf • :i1 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 2nd day of May in the year 2012: RESOLVED, that any one of the following: • Stephanie Contreras, Assistant Vice President • Kimberly Doyel, Assistant Vice President • Ernie Brede, Assistant Vice President • Rebecca Brede, 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: 5/7/12�� Michelle C. Blake, Secretary �J 9,C 11 -- loe Detail by Entity Name 9 'ROVIDENT FUNDING ASSOCIATES, L.P. iment Number IN Number Filed Event t Date Filed t Effective Date 51 TRAEGER AVENUE U ITE 100 AN BRUNO, CA 94066 ged: 02/21/2012 1 TRAEGER AVENUE JITE 100 ►N BRUNO, CA 94066 : 02/21/2012 897000000520 770323586 10/01/1997 CA ACTIVE CANCEL ADM DISS /REV 12/18/2008 NONE ;ORPORATE SERVICE COMPANY 201 HAYS STREET ALLAHASSEE, FL 32301 e & Address ment Number P93000020993 Page 1 of 2 http:H search. sunbiz. org / Inquiry/ CorporationSearch/ SearchResultDetail/EntityName /forlp -... 2/19/2014 Detail by Entity Name Page 2 of 2 ROVIDENT FUNDING GROUP, INC. 51 TRAM ER AVENUE, SUITE 100 AN BRUNO, CA 94066 Us E-Filing Services Document Searches Forms Report Year Filed Date 2011 04/04/2011 2012 02/21/2012 2013 04/16/2013 04/16L2-013 ANNUAL REPORT View image in PDF format 02/21/2012 ANNUAL REPORT view image in PDF format 04/0412011 ANNUAL REPORT View image in PDF format 04/21/2010 ANNUAL REPORT View image in PDF format 04/2412009 ANNUAL REPORT View image in PDF format 12/1912008 REINSTATEMENT View image in PDF format 06/01L2007 ANNUAL REPORT F-View image in PDF format 04L2412006 ANNUAL REPORT View image in PDF format 04106/2005 ANNUAL REPORT View image in PDF format 04/30L2004 ANNUAL REPORT View image in PDF format 02/17/2003 ANNUAL REPORT View image in PDF format 04/08L2002 ANNUAL REPORT view image in PDF format 05/04/2001 --ANNUAL REPORT View image in PDF fiorm­a-t---� 07/25L2000 ANNUAL REPORT View image in PDF format 02/04/1999 REINSTATEMENT View image in PDF format 02/04/1999 Amendment F- view image in PDF format 1 0/0111 997 Foreign LP I View image in PDF format Copyrigh Cc, and Privacy Policies State of Florida, Department of State http:llsearch.sunbiz.orgllnquirylCorporationSearchISearchResultDetaillEntityNamelforip-..- 2/19/2014 Detail by Entity Name etail by Entity Name LOANS, INC. DENT FUNDING GROUP, INC. ment Number IN Number Filed t Event nt Date Filed nt Effective Date 51 TRAEGER AVENUE UITE 100 AN BRUNO, CA 94066 hanged: 02/21/2012 ailina Address 1 TRAEGER AVENUE IITE 100 ►N BRUNO, CA 94066 :02/21/2012 F98000004548 770293745 07/30/1998 CA ACTIVE CANCEL ADM DISS /REV 10/27/2008 NONE :ORPORATION SERVICE COMPANY 201 HAYS STREET -ALLAHASSEE, FL 32301 -2525 http: // search. sunbiz. org / Inquiry/ CorporationSearch/ SearchResultDetail lEntityName /forp -f. Page 1 of 3 2/19/2014 betail by Entity Name & Address e PDVC ICA, R. CRAIG 51 TRAEGER AVENUE, SUITE 100 AN BRUNO, CA 94066 DSVP ICA, DOUGLAS 51 TRAEGER AVENUE, SUITE 100 AN BRUNO, CA 94066 DSVS KE, MICHELLE TRAEGER AVENUE, SUITE 100 BRUNO, CA 94066 Report Year Filed Date 2011 04/04/2011 2012 02/21/2012 2013 04/16/2013 04/16/2013 -- ANNUAL REPORT View image in PDF format 02/21/2012 -- ANNUAL REPORT View image in PDF format 04/04/2011 --ANNUAL REPORT View image in PDF format 04/21/2010 -- ANNUAL REPORT View image in PDF format 04/24/2009 -- ANNUAL REPORT View image in PDF format 10/27/2008 -- REINSTATEMENT View image in PDF format 04/30/2007 -- ANNUAL REPORT View image in PDF format 04/2412006 -- ANNUAL REPORT View image in PDF format 04/06/2005 -- ANNUAL REPORT View image in PDF format 05/03/2004 -- ANNUAL REPORT View image in PDF format 02/17/2003 -- ANNUAL REPORT View image in PDF format 05/29/2002 -- ANNUAL REPORT View image in PDF format 09/06/2001 --ANNUAL REPORT View image in PDF format 05/08/2000 -- ANNUAL REPORT View image in PDF format Page 2 of 3 http: // search. sunbiz. org / Inquiry/ CorporationSearch/ SearchResultDetail lEnftyName /forp -f... 2/19/2014 Detail by Entity Name 07/30/1999 -- ANNUAL REPORT View image in PDF format 07/30/1998 -- Foreign Profit View image in PDF format Copyright © and Privacy Policies State of Florida rtment of State Page 3 of 3 http: // search. sunbiz. org / Inquiry/ CorporationSearch/ SearchResultDetail lEntityName /forp -f... 2/19/2014