LA FITNESS POOL DUVAL COUNTY HEALTH DEPARTMENT FLi}RtDA DEPrtRTI�tENT 9F
John H.Armstrong,MD,FACS
Rick Scott � �
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 htta://www.floridashealth.com& www.dchd.net