1913 Selva Marina Dr TREE25-0059 10.3.25 SC TREE REMOVAL PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY
City of Atlantic Beach j CLASSIFICN
s Community Development Department
800 Seminole Road Atlantic Beach,FL 32233 PERMIT# TR6C--7-ZS_
;yJ. (P)904247-5800
PERMIT FEES
(Single-/Two-Family Residential $125.00
PERMIT REQUIRED FOR REMOVAL ❑ other $250.00
OF TREES 8 INCHES DIAMETER AT
I *-Please submit form in person
BREAST HEIGHT AND GREATER
or to buildng-dept@coab.us
SITE INFORMATION
ADDRESS 1913 Selva Marina Dr
APPLICANT INFORMATION
NAME Charlie Pineda ❑X OWNER LEGAL AUTHORIZED AGENT
ADDRESS 1913 Selva Marina Dr CITY Atlantic Beach STATE FL ZIP CODE 32233
PHONE# 2526464000 EMAIL charliepineda@aol.com
REASON FOR TREE REMOVAL
Addition to Home and dead tree
TREE REMOVAL PERMIT APPLICATION PACKAGE CHECKLIST
PLEASE ATTACH THE FOLLOWING EXHIBITS:
*Additional information may be required,depending upon circumstances unique to individual applications
❑ EXHIBIT A-TREE PERMITTING PROCESS
® EXHIBIT B(Option 1)-PROOF OF OWNERSHIP:Copy of Warranty Deed that verifies record of owner
❑ EXHIBIT B(Option 2)-LETTER OF AUTHORIZATION: Please complete if the applicant is not the owner
❑ EXHIBIT C-TREE INVENTORY and SITE PLAN
❑ EXHIBITD-TREE WORKSHEET
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IN THIS APPLICATION IS CORRECT. I AGREE TO COMPLY WITH ALL
PROVISIONS OF CHAPTER 23(PROTECTION OFTREESAND NATURAL VEGETATION)AND ALL OTHER APPLICABLE CODES AND
ORDINANCES OF THE TYATLANTIC BEACH.
Charlie Pineda 06/16/2025
SIGNATURE OF OWf4ER o PRINT OR TYPE NAME DATE
"Z
Signed and sworn before me on this -Z—�da f Q l y State of T
C'V-'0'tAQS C-6-C Q c" County of
Identification verified: LI
Oath Sworn: ❑ Yes No
TONIGINDLESPERGER otary Signature
MY COMMISSION#HH 407122
"r......o;-
:EBF F o • EXPIRES:October 6,2027 y Commission expires
TREE REMOVAL PERMITAPPLICATION 03.15.2024
VSs- 'lij EXHIBIT A: TREE PERMITTING PROCESS
1 'r City of Atlantic Beach
Community Development Department
800 Seminole Road Atlantic Beach,FL 32233
(P)904-247-5800
This document provides a general guide of the tree removal permitting process. For complete information on
permitting procedures see Section 23-23. Please sign the bottom of this page to certify that you have read this
document and understand the permitting process.
BEFORE PERMIT ISSUANCE
1. Submit Completed Application
• All trees on property must be labeled on Exhibits C and D.
2. Schedule Inspections
• All trees to be removed must be labeled with red or orange tape or ribbon and numbered per Exhibit C.
• If there is construction on property,a barricade inspection will also be done at this time.
Call for more information at(904) 247-5847.
3. Mitigation Assessment
• Mitigation shall be in the form of preservation or relocation of existing trees, replacement with new trees or
payment into the tree fund. See Section 23-33 for more information.
• Staff will review the trees proposed for removal and send the applicant a Tree Permit Calculations sheet
which outlines mitigation that is owed.
4. Proposed Mitigation Replacement Plan
• Submit a mitigation replacement plan within 30 days of receiving the mitigation calculations.
• The proposed plan must include a site plan,proposed species,and size(s). Plans must account
for all inches owed.
• A MITIGATION PLAN MUST BE SUBMITTED AND APPROVED PRIOR TO REMOVAL OF IDENTIFIED TREES.
AFTER PERMIT ISSUANCE
5. Permit Issuance
• When the permit is approved,staff will place a sign in the yard and contact the applicant.This sign must
remain until the permit is finaled.
• If paying for mitigation, payment must be made within 7 days following the issuance of the permit.
6. Mitigation Replacement
• Replacement trees must be planted within 30 days of permit issuance or prior to issuance of a Certificate of
Occupancy or Certificate of Completion.
7. Final Inspection
• After trees are planted and/or construction is complete,a final inspection must be scheduled.
• Tre lanted, preserved and relocated must survive three(3)years following the date the permit is finaled.
Charlie Pineda 06/16/25
SIGNATURE F APPLICANT PRINT OR TYPE NAME DATE
i TREE REMOVAL PERW APPLICATION-EXHIBIT A:Tree Permitting Process 03.15.2024
-s'- ►moi„ EXHIBIT B:LETTER OF AUTHORIZATION
City of Atlantic Beach
` Community Development Department
800 Seminole Road Atlantic Beach,FL 32233
(P)904-247-5800
"Please complete if applicant is not the owner
OWNER INFORMATION
NAME Charlie Pineda PHONE# 2526464000
ADDRESS 1913 Selva Marina Dr EMAIL charliepineda@aol.com
CITY Atlantic Beach STATE FL ZIP CODE 32233
AGENT INFORMATION
NAME PHONE#
ADDRESS EMAIL
CITY STATE ZIP CODE
I _ _ is hereby authorized to act on behalf of
I
the owner(s)of those lands described
in the attached application and as described in the attached warranty deed or other such proof of ownership as may
I
be required in applying to the City of Atlantic Beach,for an application related to a Tree and Vegetation Removal Permit.
1 HEREBY CERTIFY T TALL INFORMATION PROVIDED IS CORRECT:Signature of Property Owner(s)
Charlie Pineda
SIGNATURE OF R PRINT OR TYPE NAME DATE
)
�'{ Kimberly Pineda
SIGNATU O NER#2 PRINT OR TYPE NAME DAT
Signed and sworn before me on this _day of by State of
County of
Identification verified:
Oath Sworn: [] Yes ® No
Notary Signature
My Commission expires
TREEREMOVAL PERMITAPPLICATION-EXHIBIT B:LetterofAuthorization 03.15.2024
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UMBIT D: TREE WORKSHEET
City of Atlantic Beach
} Community Development Department
800 Seminole Road Atlantic Beach,FL 32233
(P)904247-5800
List the species and diameter at breast height(dbh)of all trees identified on EXHIBIT C(attach additional pages as needed).
uXn_ III:]1,= rrOu_ - —
ID 13131-1 SPECIES COMMENTS(for use by City Staff)
removing preserving relocating
1 31 Live Oak
2 24 Live Oak
3 14 Palm i
4 22 Live Oak •
5 20 Live Oak ■
6 32 Live Oak i
7 33 Live Oak i
8 27 Live Oak ■
9 28 Live Oak ■
10 32 Live Oak i
11 21 European Palm ■
i
12 24 European Palm ■
13 31 Live Oak ■
14 30 Live Oak ■
15 16 Palm ■
16 20 Palm i
17 20 Palm i
18 8 Magnolia ■
19 28 Palm i
20 16 Live Oak dead •
21 16 Live Oak dead i
22 1 Live Oak-planted this year i
23 2 Lemon !
24
Iq We,
25
TREE REMOVAL PERMIT APPLICATION-EXHIBIT D.Tree Worksheet 03.75.2024
Early Piety ,
CERTIFIED ARBORIST
INTERNATIONAL SOCIETY
OF ARBORICULTURE
TREEf�iESERVATION CONSIfLTA
ARBORIST REPORT
August 30,2023
Charlie Pineda
1913 Selva Marina Drive
Atlantic Beach,FL 32233
Mr. Pineda
At your request,I have inspected the trees on your property.In the back
right corner is a double stemmed Laurel Oak.The limbs are 18"and 21"
respectively. One of the stems has been lightning struck approximately 5
years ago and is in decline.Removal of this stem and not the adjacent stem
could set up a dangerous situation and possibly cause the failure of the
second stem. In my opinion,both of these stems are a hazard to persons and
property and for safety reasons should be removed.
Should you have any further questions please call.
3
Early Piety,President
ISA Certified Arborist#SO-0584A
Specialty Tree Surgeons,Inc.
"Specializing In Diagnosing Tree Disease"
5960 Philips Highway • Jacksonville,Florida 32216 • (904)733-4455
Email:treesrus@att.net • www.specialtytree.info
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