HomeMy WebLinkAboutInterior Renovation Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _10.21.21 Permit Number:
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P °' n= 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 RENOVATION
Lot No._
Block No.
_ New Electrical Meter —NA Second Electrical Meter_NA (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
X Mechanical _ Gas Tank —Gas Piping _ Shutters _X Windows/Doors _ Pond
_X Electric X_ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: _3,561 Sq. Ft. of First Floor: _5,473
Cost of Construction: $420,569.00 Utilities: X_ Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name —CRC HEALTH TREATMENT CLINCS, LLC
Address: _7644 S US HIGHWAY
Name: JOSEPH DEMARCO
Company: _PROJECT RESOURCES CONSTRUCTION LLC_
City: _PORT ST LUCIE_ State: FL
Zip Code: 43952 Fax:
Phone No.
Address: 11965 DEE ANN CT
City: _CONCORDState: 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 ZSUu or more, a KtCUKUED 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: X Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name: _
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: a�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 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 lendOr or an attorney before commencing work or recording our Notice of Commencement.
Signat' re of Owner/ Lessee/Contractor as Agent for Owner
STATE OF-Ft-6R1-Bftn\-�l o
COUNTY OF 0,tJ.0 0.A� %X:5--
Sworn to (or affirmed) and subscribed before me of
�E'Physical Presence or Online
Notarization
a-0 �'{- thisday of �b}�.e� �1 , 20by
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Name of person making statement.
Personally Known OR Produced IdentificationRI
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Type ofIdentification Produced Ifl
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KAREN MURPHY
_� � �'• =_ NOTARY PUBLIC
(Signat re of Notary Public- tate of