HomeMy WebLinkAboutInterior Demo Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _10.21.21 Permit Number:
of, f r
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial XXX Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 7644 S US Highway, Port St Lucie FL 34952
Property Tax ID #: 3422-441-0002-000-4
Site Plan Name:
Project Name: Acadia Healthcare Treatment Center
DETAILED DESCRIPTION OF WORK:
INTERIOR DEMOLITIO
_ New Electrical Meter _NA Second Electrical Meter NA
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: 3,561 Sq. Ft. of First Floor
Cost of Construction: $ 19,000.00 Utilities: Sewer
Lot No.
Block No.
(Affidavit required)
Windows/Doors _ Pond
Roof Pitch
: _5,473
Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name —CRC HEALTH TREATMENT CLINICS, LLC
Address: _7644 S US HIGHWAY
Name: JOSEPH DEMARCO
Company: _PROJECT RESOURCES CONSTRUCTION LLC
City: PORT ST LUCIEState: FL
Zip Code: _43952 Fax:
Phone No.
Address: 11965 DEE ANN CT
City: CONCORD State: OH_
Zip Code: 44077 Fax:
Phone No 440-622-9513
E-Mail JDEMARCO@PRCG-LLC.COM
E-Mail: JOSIAH.BECRAFT@ACADIAHEALTHCARE.COM
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License_CBC1263436
IT value oT construction is LSUU or more, a KtCUKUtU Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _K Not Applicable
Name: _
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
State
_X. Not Applicable
MORTGAGE COMPANY
Name:
Address:
City:
Zip: Phone
X Not Applicable
State:
BONDING COMPANY: >eNot Applicable
Name: _
Address:
City:
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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-bn attornev before commencine work or recording vnur NntirP of CnmmPnrPmPnt
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FIAM;DA C>VAIIO
COUNTY OF_r'U u a in0q °--
Sworn to (or affirmed) and subscribed before me of Physical Presence or
Online Notarization
this _:a 0 day of �Ch'L►� 20tIL bya,�p
Name of person making statement.
R I A L
Personally Known OR Produced Identification
Type of dentification Produced
O • Fy '%�
KAREN MURPHY
NOTARY PUBLIC
STATE OF OHIO
(Signature of Notary Public- State ofHer+da)O�i�
== ;v7;" �,.
Comm. Expires
Commission No. (Seal)
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gTF,0 F110�
08-30-2025
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