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SAINT LUCIE COUNTY FIRE DISTRICT
FIRE SAFETY PERMIT APPLICATION
S160 N.W. Milner Drive
Port Saint Lucie, FL 34983
Telephone: 772=621-3322
Fax: 772-621-3604
Web Address: www.sidd.com
Make fees payable to: Saint Lucie County Fite District
f �U 2019
Type of Request:
12'Plan Review Permit Renewal Fire Sprinkler Fire Alarm ❑ ❑ p ❑ ❑ Fixed Fire Protection Tent/s
❑ Fuel Storage/Disposal ❑ LP Storage/Disposal ❑ Fireworks Display I ❑ Fireworks Sale ❑Other
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 I/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, compliancemodification, and approval by the Saint Lucie County Fire District.
Value per Square
Square
Signature I I II Date
Value of Project
FIRE PREVENTION CODE, 2612 EDITION IS CURRENTLY ENFORCED.