CO LA Fitness 1021 Atlantic Blvd #985 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
C E R T I F I C A T E O F O C C U P A N C Y
P E R M A N E N T
Issue Date . . . . . . 12/05/12
Parcel Number . . . . . 177602-0040- -
Property Address . . . 1021 ATLANTIC BLVD
ATLANTIC BEACH FL 32233
Subdivision Name . . .
Legal Description . . .
Property Zoning . . . . TO BE UPDATED
Owner . . . . . . . . . EQUITY ONE ATLANTIC VILLAGE,
Contractor . . . . . . IMPACT CONSTRUCTION
Application number 12-00000066 000 000
Description of Work COMMERCIAL INTERIOR BUILD-OUT
Construction type . . . TYPE 5-A
Occupancy type . . . . BUSINESS
Flood Zone . . . . . .
Special conditions . .
LA FITNESS TENANT #985 ATLANTIC BOULEVARD
2007 FLORIDA BUILDING CODE WITH 2009 REVISIONS
Approved . . . . . . .
Buildin al
VOID UNLESS SIGNED BY BUILDING OFFICIAL
FLORI�3tF`h1ENT OR ,
Rick Scott � � John H.Armstrong,MD,FACS
Governor State Surgeon General
Duval County Health Department
Commercial Pool Acknowledgement
The Duval County Health Department is aware of the following pool project:
Project Name: L A Fitness Atlantic Beach
Project Location: 985 Atlantic Boulevard
Building Department Permit Number: 12-0066
The following items shall be submitted to this Department prior to pool operation:
1. A Copy of the Building departments Certificate of completion
2. Form DH 918 (Application for swimming pool operation permit)
3. Form DH 4063 (Application for Annual Renewal or Re-issuance Operating Permit)
4. Fees
5. Copy of approved plan/as-built
Acknowledgement by DCHD Official:
William R. Nowlin
Signature Print
December 3 2012
Date
Duval County Health Department
Environmental Health and Safety-Division
•900 University Boulevard N., Suite 300 MC-45 Jacksonville, Florida•32211
Phone(904)253-1280 Fax(904)253-2390 http://www.floridashealth.com& www.dchd.net
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