Michael F. Steffens Application Package missing photoMIAMI BEACH
.r6.1:tv.GN47
Last Name ,
tbrt'L \er06141-0Home Address
BOARD AND COMMITTEE APPLICATION FORM
frI2Ati,MIU-I
First Name Middle Initial
;05-4•44 0541.
City
Home Telephone Work Telephone
\tcA4 e4 4-t�F-Vy TA •
Business Name
qUa 1.4142.A4= Al K4
Business Address
Professional License (describe): A't•Cti` •
State
Zip Code
GO5* «wz. 01006 €74:12w ;lie St= rresiks• 6041
Cellular Telephone Email address
EJ
Occupation
C.0(2,11.. &iff4 kV 3313 {
City State Zip Code
Expires: ft. tion
Please attach a copy of currently effective professional license.
Pursuant to City Code section 2-22(4)a & b: Members of agencies, boards and committees shall be affiliated with the
City. This requirement shall be fulfilled in the following ways: a. An individual shall have been a resident of the City for
a minimum of six months; or b. An individual shall demonstrate ownership/interest for a minimum of six months in a
business established in the City for a minimum of six months.
• Resident of Miami Beach for a minimum of six (6) months: Yes Zt or No
11
• Demonstrates ownership /interest in a business in Miami Be c for a minimum of six months: Yes I J or No
• Are you a registered voter in Miami Beach: Yes Zi or No
• I am now a resident of: North Beach IZt South Beach Lj Middle Beach
• I am applying for an appoin ment because I have specipl abi 'ties, knowledge and experience. Please list below:
16•4 G 4ilsze )1G Hi4Tt21c, 1,cc•i✓scft irpsta 1 itevi 73veLAFrn +K
• Are you presently a registered lobbyist with the City of Miami Beach? Yes Z1 or No
Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that
only three (3) choices will be observed by the Office of the City Clerk.
0 Affordable Housing Advisory Committee
❑ Health Advisory Committee
❑parks and Recreation Facilities Board oo
E Art in Public Places Committee
❑ Health Facilities Authority Board
0 Personnel Board
0 Audit Committee
n Hispanic Affairs Committee
Planning Board*
D Board of Adjustment **
AHistoric Preservation Board*
0 Police Citizens Relations Committee
0 Budget Advisory Committee
0 Housing Authority
0 Production Industry Council
0 Committee on the Homeless
0 Human Rights Committee
0 Sister Cities Program
❑ Committee for Quality Education in MB
❑ LGBT Advisory Committee
❑ Sustainability Committee
0 Convention Center Advisory Board
0 Marine & Waterfront Protection Authority
0 Transportation, Parking, & Bicycle -Pedestrian
Facilities Committee
0 Cultural Arts Council
0 Miami Beach Commission for Women
0 Visitor and Convention Authority
(Design Review Board*
vv
0 Normandy Shores Local Government
Neighborhood Improvement
0 Youth Commission
0 Disability Access Committee
* Board members are required to file Form 1 — "Statement of Financial Interest" with the State.
*If you seek appointment to a professional seat (e.g., lawyer, architect, etc.) on the Board of Adjustment, Design Review
Board, Historic Preservation Board or Planning Board, attach a copy of your currently -effectively license, and furnish the
following information: LL /�
Type of Professional License / 4t4. ►fiv�v4 License Number An OC'Oho11.
License Issuance Date /.• tc License Expiration Date 17.• 11
Page 1 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06142016.docx
°O Note: If applying for the Youth Center positions of the Parks and Recreations Facilities Board, please indicate your affiliation with
the Scott Rakow Youth Center and/or the North Shore Parks Youth Center:
• Please describe your past service with the City's Youth Centers (include dates of service):
• Present participation in Youth Center activities by your children: Yes No IJ
If yes, please list below the names of your children, their ages and the programs in which they participate:
Child's name: Age:
Child's name: Age:
Program:
Program:
• Have you ever been convicted of a felony? Yes La or No
If yes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach Code? Yes I...r" or NoU If yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money? Yes or No.1X1 If yes, explain in detail:
• Are you currently serving on any City Board or Committee? Yes
►4
or No If yes, which board/committee?
• In what organization(s) in the City of Miami Beach do you currently hold membership?
Name ft
Position
Name Position
• List all properties owned or in which you have an interest within the City of Miami Beach:
0 P
• Are you now employed by the City of Miami Beach? Yes or No
.ii
Which department and title?
• Pursuant to City Code Section 2-25 (b): Do you av a parent , spouse child brother or sister who is
employed by the City of Miami Beach? Yes or No
If "Yes," identify person(s) and department(s):
►LI
The following information is voluntary and is neither part of your application nor has any bearing on your consideration for
appointment. It is being asked to comply with City diversity reporting requirements.
Gender: Male
g1
Female
Race/Ethnic Categories
What is your race?
�yAfrican-American/Black
4� Caucasian/White
Asian or Pacific Islander
I_ Native-American/American Indian
Page 2 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06142016.docx
Other— Print Race:
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No" box if not Spanish, Hispanic, Latino/a.
t4No
LA Yes
Do you consider yourself Physically Disabled?
[1:J
No
I Yes
NOTE: IF APPOINTED, YOU WILL BE REQUIRED TO FOLLOW CERTAIN LAWS THAT APPLY TO CITY BOARD/COMMITTEE
MEMBERS. THESE LAWS INCLUDE, BUT ARE NOT LIMITED TO:
o Prohibition from directly or indirectly lobbying City personnel (Miami Beach City Code section 2-459).
o Prohibition from contracting with the City (Miami -Dade County Code section 2-11.1).
o Prohibition from lobbying before the board/committee you have served on for period of one year after leaving office (Miami Beach
City Code section 2-26).
o Requirement to disclose certain financial interests and gifts (Miami -Dade County Code section 2-11.1).
o CMB Community Development Advisory Committee: prohibition, during tenure and for one year after leaving office, from having
any interest in or receiving any benefit from Community Development Block Grant funds for either yourself, or those with whom
you have business or immediate family ties (CFR 570.611).
o Sunshine Law - Florida's Government -in -the -Sunshine Law was enacted in 1967. Today, the Sunshine Law regarding open
government can be found in Chapter 286 of the Florida Statutes. These statutes establish a basic right of access to most
meetings of boards, commissions and other governing bodies of state and local governmental agencies or authorities.
o Voting conflict — Form 8B is for use by any person serving at the county, city or other local level of government on an appointed or
elected board, council, commission, authority or committee. It applies equally to members of advisory and non -advisory bodies
who are presented with a voting conflict of interest under Section 112.3143, Florida Statutes.
Upon request, copies of these laws may be obtained from the City Clerk.
I HEREBY ATTEST TO THE ACCURACY AND TRUTHFULNESS OF THE APPLICATION; AND I HAVE RECEIVED, READ AND
WILL ABIDE BY CHAPTER 2, ARTICLE VII, OF THE MIAMI BEACH CITY CODE, ENTITLED "STANDARDS OF CONDUCT FOR
CITY OFFI ERS, EMPLOYEES AND AGENCY MEMBERS AND ALL OTHER APPLICABLE COUNTY AND/OR STATE LAWS AND
STATUTE CCORDINGLY."
Applicant'] Sjgn
Received in t
ture
10.2410 MicAism1 6 e"5
Date Name of Applicant (PLEASE PRINT)
ffice of the City Clerk by: 44044. H Z6�t /101 /66 off//(
Name of Deputy CCClerk Control No. Date
ATTACH A CURRENT RESUME, PHOTOGRAPH AND A COPY OF ANY
APPLICABLE PROFESSIONAL LICENSE.
ATTACH ADDITIONAL SHEETS, IF NECESSARY, TO PROVIDE REQUIRED
INFORMATION.
Page 3 of 4
F \CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06142016.docx
MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www.miamibeachfl.gov
OFFICE OF THE CITY CLERK
CityClerk@miamibeachfl.gov
Telephone: 305.673.7411 Fax: 305.673.7254
Acknowledgement of fines/suspension for Board/Committee Members for failure to comply with Miami -
Dade County Financial Disclosure Code Provision Code Section 2-11.1(i) (2)
Board Member's Name: • lc�►A.l `-- 1."
I understand that no later than July 1, of each year all members of Boards and Committees of the City of
Miami Beach, including those of a purely advisory nature, are required to comply with Miami -Dade County
Financial Disclosure Requirements. This means that the members of City Advisory Boards, whose sole or
primary responsibility is to recommend legislation or give advice to the City Commission, must file, even
though they may have been recently appointed.
One of the following forms must be filed with the City Clerk of Miami Beach, 1700 Convention Center Drive,
Miami Beach, Florida, no Tater than 12:00 noon of July 1, of each year.
1. A "Source of Income Statement"
2. A "Statement of Financial Interests (Form 1)"
3. A Copy of your latest Federal Income Tax Return
Failure to file one of these forms, pursuant to the Miami -Dade County Code, may subject the person to a fine
of no more than $500, 6(5 day �j ' or both.
to IA. tk,,
Signature
Updated: Tuesday, October 04, 2016
Page 4 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06142016.docx
Date
Neville/Steffens Architects LLP
Gregory A. Neville AR 0012197
F. Michael Steffens AR 0011052
F. MICHAEL STEFFENS
EDUCATION
Rice University, Houston, Texas Masters of Architecture 1984
University of Florida, Gainesville, Florida Bachelor of Design in Architecture 1981
REGISTRATION
Florida Personal
Florida Corporate
AR 0011052
AA 0003466
EXPERIENCE
Neville/Steffens Architects LLP was formed in December of 1999 for the practice of architecture,
interior design, planning, and related design services. Mr. Steffens project responsibilities
encompassed the public sector and corporate and private clients who express a desire for quality in
the built environment.
Mr. Steffens has lived in South Florida for 55 years and in Coral Gables for 30 years. Mr. Steffens is
currently serving on the City of Miami Beach Design Review Board. He is past Vice Chairman of the
Coral Gables Planning and Zoning Board and past Chairman of the City of Miami Beach Design
Review Board. He also served on the Coral Gables Board of Architects and the Coral Gables Historic
Preservation Board.
Specific Food Service Projects Include:
• Le Zoo Restaurant, Bal Harbour
• Pisco y Nazca Restaurants, Kendall & Doral
• La Goulue Restaurant, Bal Harbour
• STK Restaurant, Miami Beach
• Bagatelle Restaurant, Miami Beach
• Yuga Restaurant, Coral Gables
• The Daily Restaurant, Miami
• Upland, Miami Beach
Other South Florida Projects Include:
• Chaminade-Madonna High School Performing Arts Facility, Hollywood
• Chaminade-Madonna High School Athletic Fields and Facilities, Hollywood
• 2320 Ponce de Leon Office Building, Coral Gables
• Miami International Airport Terminal E Renovation
• Coral Gables City Hall Restoration
• St Moritz Hotel Renovation, Miami Beach
• Bass Museum Historic Renovation Consultant, Miami Beach
• Anchor Place Shops and Parking Garage, Miami Beach
• China Grill Restaurant, Las Olas Riverfront Shops
• Morton Towers Addition and Renovation, Miami Beach
• Bet Shira Synagogue, Miami
• B'nai Israel Synagogue and School, Boca Raton
• Toussaint L'Ouverture Elementary School, Miami
• Numerous Historical Residential Restorations
316 Miracle Mile
Coral Gables, Florida 33134
Telephone 305-448-5299
Facsimile 305-444-0842
STATE OF FLORIDA
\ DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
BOARD OF ARCHITECTURE & INTERIOR DESIGN (850) 487-1395
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399-0783
STEFFENS, FRANCIS MICHAEL III
316 MIRACLE MILE
CORAL GABLES FL 33134
Congratulations! With this license you become one of the nearly
one million Floridians licensed by the Department of Business and
Professional Regulation. Our professionals and businesses range
from architects to yacht brokers, from boxers to barbeque restaurants,
and they keep Florida's economy strong.
Every day we work to improve the way we do business in order to
serve you better. For information about our services, please log onto
www.myfloridalicense.com. There you can find more information
about our divisions and the regulations that impact you, subscribe
to department newsletters and learn more about the Department's
initiatives.
Our mission at the Department is: License Efficiently, Regulate Fairly.
We constantly strive to serve you better so that you can serve your
customers. Thank you for doing business in Florida,
and congratulations on your new license!
DETACH HERE
RICK SCOTT, GOVERNOR
STATE OF FLORIDA
Ss t4. DEPARTMENT OF BUSINESS AND
iy S.p
PROFESSIONAL REGULATION
AR0011052 ISSUED: 12/15/2014
ARCHITECT
STEFFENS, FRANCIS MICHAEL III
IS LICENSED under the provisions of Ch.481 FS.
Expiration date ' FEB 28, 2017 L1412150000656
KEN LAWSON, SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
BOARD OF ARCHITECTURE & INTERIOR DESIGN
LICENSE NUMBER
The ARCHITECT
Named below IS LICENSED
Under the provisions of Chapter 481 FS.
Expiration date: FEB 28, 2017
STEFFENS, FRANCIS MICHAEL III
316 MIRACLE MILE
CORAL GABLES FL 33134
ICC! IFn• 1 )111.i7nIe (IMP! AV AR PPr I IIRFf RV 1 A1A/
SFr] it 1 14171 srinnossA