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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:Permit Numher:s\45-d��5
RECEIVE!
Mr EIM; -��. MAY 1.71019
o -
g' a ,1• = _ - � Buildin Permit A lication Permlttfng DeOrtment
�� St. Lucie County
Planning and Development Services
Building and Code Regulation Division Commercial x Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: ACADIA HEALTHCARE CTC
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Address: 7664 S US HWY 1 PORT ST. LULIE l-L. 349b2
Property Tax ID #: 3422-441-0002-000-4 Lot No.
Site Plan Name: Block No.
Project Name: CRC HEALTH CORP
ALARM SYSYEM :,INSTALL BURGLAR ALARM CCTV CAMERAS SYSTEM, KEYPAD, WIRELESS RECEIVER,
CELL COMMUNICATOR, DOOR CONTACTS, AND MOTION DETECTORS
New Electrical Meter Second Electrical Meter.
Additional work to be performed under this permit- check all that apply:
_Mechanical ^ Gas Tank Gas Piping _ Shutters ` Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ hoof Pitch
Total Sq. Ft of Construction:
Cost of Construction:
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic Building Height:
Name `1 v1did E e J 01a,
Address: b6ti1 fr-x i V1 )11 "14 010
City: Ran J�a tl State: L-
Zip Code: 3'14 A 5 % Fax:
Phone No. `y- -Z 0 :?-gi 66 0
E-Mail: Lcsh M &-ftakr",y _Mc, _ux
Fill in fee simpi Title Holder on next page (tf efferent
from the Owner listed above)
dame: Guillermo Gonzalez
Company: Johonson Controls Security Solutions
Address: 1830 s Park Lane
City: Jupiter State: Florida
Zip Code: 33458 Fax:
Phone No 561-207-3529
E-Mail guillermo.gonzalez@jci.com
State or County License EF 20000574
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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A MEW
N R
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Nat Applicable
BONDING COMPANY: _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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an9covenants that may restrict or prohibitsuch
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 roams and accessory uses to another non-residential use
WARN I NG TO OWNER. Your failure to Record a Notice of Commencement may result in paying twice for
improvements ' t your p,pperty. A Notice of Commencement must be recorded in the public records of St,
Lucie Countyr�ind pos�edon the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an at me before commencing work or recording your Ne of Commencement,
'Signature of Owner/ Lessee)tontractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF 06 27ec-
STATE OF FLORIDA
COUNTY OF. P ' ) fh
-f(] 0
Swor b (or affirmed) and subscribed before me of
Sworn to (oraffirmed) and subscribed before me of
PrpPhys�jicrz I Presenr-e or Onlind Notarization
x Physical Presence or Online Notarization
this'Z-'7 day of AP(LI 2020 by
this 22 dayof . APRIL 202f by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced identification
Type of Identi .fi ication
Type of Identification
Produced VL
Produced
Ak�j
(Signature of Notary Public- State of Floridof
o NOTARY f
Ft&1&%VLLlAM0$
UgWairure of Rota q %ate of Florida
P211c - State
STATE OF
Commission No. Gomm# G(;l
F 70taTy
ORID-A jHH % alg82116
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VX 025
?%Tlssion No. Ex ;a 19, 2025
E I Expires 9/
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tbrotio N ryAssn,
17/2022 Benced through NatiOnAt "Ot"
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20