HomeMy WebLinkAboutRECEIPT OF APPLICATIONSCANNED
BY
St. Lucie County
FLORIDA DEPARTMENT OF HEALTH
PALM BEACH C TY
PUBLIC POOL PROGRAM
HEALTH RECEIPT OF APPLICATION
Project Location
(Street Address, City, Zip Code)
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13LIOC, Nun
lV4.1v, e%.klj 34440
Applicant Information
(O1wner/Agent Name, Contact #)
I
44P'rioo-4J KOYAG4� d CCr
17z- 13,1e— 300,.E
This is to acknowledge receipt of an application for a public swimming pool.
You have met the preliminary submittal requirements of Chapter 514.03(1),
Florida Statutes (FS), and may file an application for a public pool
construction/modification permit with your local building authority. The
department will review your application for completeness and notify you and
the local building authority of any critical health and safety code
Inconsistencies found in your prqobfl that must be addressed before a new
operating can ued. Th�torida Department of Health
or revised permit
(FDOH) may request alirtnal inforrQltion within 30 days.
REQUEST E/QPC NTATION
NEW POOL
La
OTHER
CONSTRUCTIONR'oB*lc4O
(Describe Below)
DOH Fo F
i
4,
Pool Plans & Specifications
Letter of A zation L,
L.
OTHER
(Describe Below)
FINAL INSPE N
e 3660
Please provide any changes to the application or plans submitted prior to
requesting an inspection. After construction is completed and prior to
opening, FDOH must conduct an initial inspection. When requesting your
Inspection the following documents may be required:
A set of plans and specifications as approved for construction by the
local building authority,
9. A copy of the final inspection from the local building authority as
fined in section 553.71, FS.,
3. The annual operating permit fee.
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Date Received: Re ived y:
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Not Valid Without ereived Stamp