HomeMy WebLinkAboutZoning Compliance Home Use PERMIT# ®l �� RECEIPT#
Planning &Development Services Department
IF
Building& Code Regulations
• 2300 Virginia Ave
Fort Pierce,FI 34982
772-462-1553
APPLICATION FOR ZONING COMPLIANCE—HOME OCCUPATION
Dante: 11 C1 2c)20
Business Name: ��� C LLu-n
Business Address: I I
Description of Type of Business: PHONE AND OFFICE USE ONLYfor
Property Tax ID#:
_ n
Applicant's Name: ► re f 1 `� �� GI��� Phone:
Applicant's Address:
City: LU LC-Q— State: 1 L Zip: (-�)`Cq cS Z-
I HEREBY ACKNOWLEDGE THAT THE ABOVE IS CORRECT AND AGREE TO CONFORM TO THE
ST.LUCIE COUNTY ZONING AND BUILDING CODE. ANY VIOLATION OF SECTION 8.01.00
"HOME OCCUPATION"WILL BE PURSUED THROUGH ST.LUCIE CODE ENFORCEMENT.
C-
Z-ast-cu-n S
Applicant's Signature
OFFICE USE ONLY
Date: Initials:
Subdivision: Block: Lot:
Section: Township: Range: Map#:
Zoning: Land Use:
Certificate of Competency Required: No Yes Number
Type of Certification:
SLCPDSD Revised 5/1/2014
RON DESANTIS
GOVERNOR
MARYC.MAYHEW
SECRETARY
September 15,2020
Dorett Williams,Administrator File Number:39972232
Palladium Professional Care Services,LLC License Number:237014
115 East Alden Street Provider Type:Homemaker and Companion
Fort Pierce,FL 34952 Services
RE:115 East Alden Street,Port Saint Lucie,FL 34952
Dear Dorett Williams,
The enclosed Homemaker and Companion Services license with license number 237014 and
certificate number 28984 is issued for the above provider effective September 15,2020 through
September 14,2022.The license is being issued for approval ofthe initial application.
Review your certificate thoroughly to ensure that all information is correct and consistent with
your records. If errors are noted,please contact the Home Care Unit.
Please take a short customer satisfaction survey on our website at ahca.myflorida.com/survey/to
let us know how we can serve you better. Additional licensure information can be found at
http://ahca.myflorida.com/longtermcare.
If we may be of further assistance,please contact me by phone at(850)412-4390 or by email at
Anaelle.Gelin@ahca.myflorida.com.
Sincerely,
Anaelle Gelin
Home Care Unit
Division of Health Quality Assurance
2727 Mahan Drive t74S#33 y'r` Facebook.com/AHCAFIorida
Tallahassee, FL 32308 Youtube.com/AHCAFIorida
AHCA.MyFlorida.com ? Twitter.com/AHCA_FL
SlideShare.net/AHCAFIorida
I
I
I
I
I I
i
I
i
I
I
I
i
View current license information at:FloridahealthSnder.gov REGISTRATION#: 237014
CERTIFICATE#: 28984
I
State of Florida
AGENCY FOR HEALTH CARE ADMINISTRATION
DMSION OF HEALTH QUALITY ASSURANCE
Homemaker and Companion Services
REGISTERED
This is to confirm that PALLADIUM PROFESSIONAL CARE SERVICES,LLC has complied with the rules and regulations adopted
by the State of Florida,Agency for Health Care Administration,and authorized in Chapter 400,Part R Florida Statutes,and is
authorized to operate the following:
PALLADIUM PROFESSIONAL CARE SERVICES,LLC
115 East Aldea Street
Port Saint Lucie,FL 34952
in the following counties:
INDIAN RIVER,MARTIN,OKEECHOBEE,PALM BEACH,and ST.LUCIE
r q
re' 'R'e, ��'•.
EFFECTIVE DATE:09/15/2020
EXPIRATION DATE:09/14/2022 �� :` Srurl:u. .AuelkA.\ 16111r:dllt..':ue A.Inwushidion
I "
I
I
I
I
I