HomeMy WebLinkAboutFIRE SAFETY PERMIT APPLICATIONSAINT LUCIE COUNTY FIRE DISTRICT
FIRE SAFETY PERMIT APPLICATION
5160 NX. Milner Drive
Port Saint Lucie, FL 34933
2r8S1
Telephone: 772-621-3322
Fax: 772-62 3 -36iD4
Web Address: www.slcf,,J.conI
Make fees Payable to; Saint Lucie County Eire Sistrict
Type of Request.
Plan Review Permit Renemial j� Fire Sprinkler (� ,tire Alarm a Fbxed Fire Protection
EFuel 5torage/Disposal [] LP Sforage/Disposa� [] Fireworks Display pFireworks Sale (� Oth2r
Contractor Affidavit: 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 said permit. In the consideration of granting this requested permit, I do herby agree that 1/we will, in all respects, perform the work and
installation in accordance with the approved plans, the applicable, Florida Fire Prevention Code, Saint Lucie County Fire District Resolution, Florida Building Code, and
the N.F.P.A Codes. A plan revision after the issuance of the permit is subject to approval by the Saint Lucie County Fire District. All work and installation as indicated is
subject to field inspection, compliance modification, and approval by the Saint Lucie Countv Fire Distrirr
av" rv-vruLJ)t-3 II-0,1111; 3�i�;F�'dra ?I'J'l i�� CODE, 201 -91 2 EDO s 90M OS CURRENTLY ENFORCED.
Scope of worlc /� / _ ) �)
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Invoice
Invoice Number:
w
Date:
p5eptember8, 2021
Job Name.
nan
Job Address:
ean Drive # 1501 Jensen Beach
Company:
Bay Homes
Address:
iver Ct
P34957
City:
ach
State/Zip Code:
Phone:
Fax:
mesl@gmaiLcom
ffBarry
Contact Name:
Community Risk Reduction Division
Saint Lucie County Fire District
5160 NW Milner Drive
Port Saint Lucie, Florida 34983
Phone: 772-621-3322
Fax: 772-621-3604
www.slcfd.com
Item Description Quantity
1 Plan Review (Valuation $70,000 x .0036 = $252,00)
Unit Price
Amount
$252.00
$252.00
SLC Permit # 2108-0222
FIRE PREVENTION
5160 NW MILNER
PORT ST LUCIE, FL 34983
7726213343
Cashier: Carl T.
Transaction 001406
Total $252.00
CREDIT CARD SALE 8252.00
VISA 9126
08-Sep-2021 3:09:46P
$252.00 I Method: KEYED
VISA XXXXXXXXXXXX9126
MANUALLY ENTERED
Reference ID: 125100506518
Auth ID: 008'100
MID:********0886
omments: FEES ARE DUE UPON RECI AthNtwkNrn: VISA
Sub -total
$252.00
Fire Marshal plan review ar SIGNATURE VERIFIED
reviewed or scheduled unt
fees are separate from Buili Online: https://clover.com/p
Lucie County Fire District R /WSS5T6WHZVFDO
Grand Total
$252.00
�ayiiieul vv6J3l bWHLVFDO
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