HomeMy WebLinkAboutBuilding Permit & Subcontractor AgreementAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
ST. LUCIE z;
CQUNTY
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential X
PERMI I APPLICATION FOR: CIM - Construction In Motion, Inc
PROPOSED IMPROVEMENT LOCATION:
Address: 366 SE Naranja Ave, Port St Lucie, FL 34983
Property Tax ID #: 3419-530-0026-000-1
Site Plan Name:
Project Name: Jenny Lynn Bailey
DETAILED DESCRIPTION OF WORK:
Remove portion of Structural Wall & 8 High Hats (LED)
New Electrical Meter NIA Second Electrical Meter N/A
CONSTRUCTION INFORMATION:
Lot No.26
Block No. 32
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
1lectric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq, Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2,000.00 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Jenny Lynn Bailey
Name: Gregory White
Address: 366 SE Naranja Ave,
Company: CIM - Construction In Motion, Inc
City: Port St Lucie, FL State: _
Zip Code: 34983 Fax:
Phone No. 321,747,8821
Address: 733 SE Norcross Ave,
City: Port St Lucie, State: FL
Zip Code: 34983 Fax:
Phone No 772.807.2155
E-Mail: Jennybaileycrna@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail JimB@cim-constructioninmotion.com
State or County License CGC060478
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name: Joseph Simmons
Name:
Address: 7619 Gramercy Drive
Address:
City: Gdando• State: FL
City: State:
Zip: 32818 Phone 407.454.1890
Zip: Phone:
FEE SIMPLE TITLEHOLDER: x Not Applicable
BONDING COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an before commencingwork or record!n our Notice of Commencement.
//attorne
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Signature of 0 ne Lessee/Co tractor as Agent for Owner
ontra or/ icense Holde
Signature of Contractor/7
STATE OF FLO A
COUNTY OF . L.UCA C-
STATE OF FLORIr4
COUNTY OF �5
Swoyn to (or affirmed) and subscribed before me of
V Ph�sical Presence or Online Notarization
this V� day of Mail , 202q by
Sworn to (or affirmed) and subscribed before me of
V Physical Presence or Online Notarization
this 016.may of T 2024 by
GytigorIA < %A-t
GYI o� X4 wk%% C
Name o erson mak'/ing statement.
Personally Known " OR Produced Identification
Name of erson making statement.
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produclitcl.
Produ ed
(Signature of Nota
C,G3M 15L
Commission No.
_'
-
(Signature of Notary
GG�Ig�
Commission No.
GRISELCORTES
;: MY COMMISSION �+$�@ 55
Bonded Thu No Publk Undemiilers
CORT[S
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?(� 7COMM1,SSSION
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2,202RES:J=NJPublic Umdemiilers
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETE D
Rev. 5/6/20
PERMIT # ISSUE DATE 1 7
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Light and Power Electrical Services, Inc. have agreed to be
(Company Name/Individual Name)
the Electrician Sub -contractor for CIM - Construction In Motion, Inc
(Type of Trade)
(Primary Contractor)
For the project located at 366 SE Naranja Ave, Port St Lucie, FL 34983 - Tax ID # 3419-630-0026-000-1
(Project Street Address or Property Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change ofSub-contractor notice.
CONTRACTOR SI�.fNATURE (Qualifier)
Gregory White
PRINT NAME
31330
COUNTY CERTIFICATLON NUMBER
Slate of Florida, County ofs}•W,• to\
The foregoing instrument was si tied before me this �0 day of
�_,2oal,by�—tr_ eQ �tA�hl�-C
who is personally (mown or has produced a
as identification.
STAMP
Signature of Notary Public ^^
t1YOOMORISE(OORTEMI$SJoi S
311756
5 R FxPlltES:r�k,2o23
Print Name of Notary Public o. �� wa Thm kb navainis
Revised I I/16/2016
SUBCONTRACTOR SIGNATURE (Qualifier)
Bo Moskoskov
PRINT NAME
COUNT RTIFICATION NUMBER
State of Florida, County of 5�-
The foregoing instrument was signed before me thistiny of
L1
who is personally (mown _or has produced
�a r{f. L
as identification.
30F STAMP
Si re of Notary Public
rCxJ6rn C-PerrAOJ
Print Name of Notary Public
,��Y PUBc BRADEN GERDES
2��4 CommissionANH05&871,
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