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POE'S DOG DINING PERMIT 2011 yes_ CITY OF ATLANTIC BEACH '"" �� 800 SEMINOLE ROAD `"� ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Application Number 11- 00100060 Date 10/12/11 Property Address 363 ATLANTIC BLVD UNIT 01 Application type description DOG - FRIENDLY DINING APPLICATION Property Zoning TO BE UPDATED Application valuation . . . 0 Application desc DOG DINNING Owner Contractor POE'S OWNER PO'S RESTAURANT ATLANTIC BEACH FL 32233 Permit DOGS ALLOWED OUTDR FD SERV ARA Additional desc . Permit Fee . . . 175.00 Plan Check Fee .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 10/11/12 Special Notes and Comments APPROVED TO PROCESS CHECK PERMIT VALID UNTIL SEPT. 30, 2011 Fee summary Charged Paid Credited Due Permit Fee Total 175.00 175.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 175.00 175.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ' City of A fdan& Beach OG FRIENDLY RESTAURANT PERMIT APPLICATION "p . s (Per Ordinance No. 95- 10402) 1. FOOD SERVICE ESTABLISHMENT INFORMATION: PHONE # NAME OF ESTABLISHMENT Tnvex y SEA � FL DHR # �` 24 I 2462.. PROPERTY ADDRESS 14 ,,_, /� IAI 1 .- ? \ G r(�1 C1 ' .} AB BTR # 1 2 S - 0009 74-26 � j� L CITY, STATE, ZIP ,Qn c \"' h ` �! Ge 2 3'3 FAX # 0 � EMAIL ADDRESS et l, V •, 1_J 2. APPLICANT INFORMATION: NAME OF APPLICANT Rldrkl d L v‘Cx / Ere! C yAN Sua Y RI :in. 4, = _. ` G Requirements 1re1flCRequirements COMPANY * * : MAILING ADDRESS # I t1 ` 1 1P,Y a + G1 Application Fee: $175 r.. CCIY, STATE, ZIP F , 1 • k y . �_ . r Completed Permit EMAIL ADDRESS r� . N+Ar 1., G , M A pplicat i on Form i�'LAI " _ S.'1 F AX # W t PHONE # (.(1 Proof o of Ownership p,. 3. PROPERTY OWNER INFORMATION, IF DIFFERENT FROM APPLICANT: Auth Agee# NAME OF OWNER AJJidavits (If applicable) le COMPANY .J^ C �] �r�v+�P Proof of r MAILING ADDRESS 3 5 . � i1 1 +, �. '�,(` ' k_ilr m � ^ +�' _y Diagram of Designated CFFY, STATE, ZIP YV4q �� l ` 1 r � t k 1 Outdoor Dining Area EMAIL ADDRESS (( �/^ \ 02.0c10 lid Pre- Application PHONE # ( M1 - '4a, • Ci t J`1 FAX # Consultation Form l UVx 32% 4. PROOF OF OWNERSHIP: 6. DAYS & HOURS Please check the box of the applicable document and attach a copy to this form. DOGS ALLOWED: FAINAL COUNTY PROPERTY RECORD CARD r DUVAL COUNTY RECORDED DEED P.SUN Iiqw - 1 5. PROOF OF INSURANCE: fi MpN r Please provide an original certificate of insurance, or have your agent fax a copy of your certificate providing �+ . TUE commercial general liability insurance in the amount of five hundred thousand dollars ($500,000.00) per (- WED occurrence and one million dollars ($1,000,000.00) aggregate. The policy shall not have exclusions far u/ animal bites. All insurance shall be from companies duly authorized to do business in the State of Florida. r 'MU Thirty (30) days written notice must be given to the City of Atlantic Beach Risk Management prior to any cancellation or reduction in policy coverage. The City of Atlantic Beach Risk Management (800 Seminole v FRI Road, Atlantic Beach, FL 32233) mast be listed as a certificate holder. ( SAT iI I HAVE READ THE INFORMATION IN THIS APPLICATION AND UNDER PENALTIES OF PERJURY, I DECLARE THAT THE FACTS STATED IN THIS APPLICATION ARE TRUE. ‘ .-- 4 -- gei )fro,-----:? ' RICkAiCt- L•I Okir1 4af a EI/40( /ba. It APIinCANTSSIGNIJRE APPLICANTS PRINTED NAME DATE DOG_v2011.01 1:07:51 PM 10/12/2011 Licensee Details Licensee Information Name: POE'S TAVERN -JAX BEACH, LLC (Primary Name) POE'S TAVERN (DBA Name) Main Address: 86 OCEAN BLVD ATLANTIC BEACH Florida 32233 County: DUVAL License Mailing: 86 OCEAN BLVD ATLANTIC BEACH FL 32233 County: DUVAL LicenseLocation: 363 ATLANTIC BLVD #1 ATLANTIC BEACH FL 32233 County: DUVAL License Information License Type: Permanent Food Service Rank: Seating License Number: SEA2612482 Status: Current,Active Licensure Date: 08/25/2011 Expires: 06/01/2012 Special Qualifications Qualification Effective Plan Review 07/21/2011 Duval JUN View Related License Information View License Complaint View Recent Inspections Contact Us :: 1940 North Monroe Street, Tallahassee FL 32399 :: Call.Center @dbpr.state.fl.us :: Customer Contact Center: 850.487.1395 The State of Florida is an AA /EEO employer. Copyright 2007 -2010 State of Florida. Privacy Statement Under Florida law, e-mail addresses are public records. If you do not want your e -mail address released in response to a public- records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions regarding DBPR's ADA web accessibility, please contact our Web Master at webmaster dbpr.state.fl.us. Sip 261 2482. SHOPPES OF NORSHORE LLC Primary Site Address Official Record Book /Page PO BOX 330108 363 ATLANTIC BLVD 14858 -01983 Tde # ATLANTIC BEACH, FL 32233 Atlantic Beach FL 32233 9421 363 ATLANTIC BLVD Property Detail Value Summa RE # t 1 1697300000 9 � Tax Dletrid 1 USD3 Value Method Income Income ___. Total Building Value $0.00 $0.00 Extra Future Value 1 $0.00 ...- $0.00 _..- Legal peso 5-69 21 NTIC 25 -29E EACH 1.65 lent Value (Market) $1,796,131 00 1 $1,796,131.00 j ATLA B .. .... .. -. t ...- _... -, - .... Land Value (Ayric) $0 00 $0.00 _ -.... Subdivision ! 03101 ATLANTIC BEACH _._. ...... ......... ___ ...- Just (Market) Value 1 $ 3 , 400 , 600 . 00 $3,192,400.00 " - The sale of this property may result in higher property fazes. For more information go to Save Our Homes and our PrapeDy Ta?. Assessed Value I $3,400,600.00 $3,192,400.00 Estimator . Property values, exemptions and other Information listed as In Progress' are subject to change. These numbers are part "' ' - -- -- o the 2011 working tax roll and will not be certified until October. , 1,. , • •., r , -,.. - • s „i,,,- , r, ...w - - -, Cap Diff /Portebilky Amt $0.00 / §0 00 §0 00 / $0 00 Exemptions See below 1 $ 0.00 - . - -.... - ......_._ _ _- ..w... .....- ._._._ _ Taxable Value 93,400,600.00 • See below Sales History Book /Page I Sale Date I Salo Price Dedinstroment TvwCode i Qualified /Unqualfled 1 Vaunt /Improved 14858 -01982 1 3/31/2009 1 $100.00 WD - Warranty Deed I Unqualified 1 Improved 14811 -01J15 1 3/31/2009 I $3,850,000.00 WD - Warranty Deed (Qualified 1 Improved 99344 -0933 I 5/25/1999 1 92,469,800.00 1 WO - Warranty Deed I Qualified Improved 07708 - 01113 I 10/23/1993 1 $100.00 WD - Warranty Deed • Unqualified Vacant 06935-00666 ' 7/23/1990 I $800,000.00 WD - Warranty Deed I Qualified t Vacant 03287- 00578 10/19/1971 $13,400.00 MS - Miscellaneous !_ Unqualified l Improved Extra Features I.01 ( Eaature Cade 1 Feature Description , Bldg. 1 Length i Width I Total Units Value 1 I PVAC1 I Paving Asphalt 1 1 1 0 i 0 . 28,891.00 2 j FWDC1 Fence Wood $15,774.00 • !1 30 j {21.00 (§46.00 3 I LPMCI Light Pole Metal • 1 1 • 0 1 0 1 3.00 913.00 4 • LITC1 Lighting Fixtures 11 1 0 0 5 • i ! 5.00 $850.00 • 5 1 FWDC1 Fence Wood • 2 1 0 • 0 I 67.00 ` 9196.00 6 l PVCC1 I Paving Concrete 1 2 0 1 600.00 0 I 1 9619.00 7 f PVAC1 I Paving Asphalt 1 3 0 (0 9,154.00 I $5,236.00 8 1 PVCC1 1 Paving Concrete 1 3 1 0 • 0 914.00 ff 9943.00 9 I LPMC1 I Light Pole Metal 13 10 0 • 1.00 10 I LITC1 Lighting Furtures I $304.00 • 3 ` 0 1 0 II 1.00 f $170.00 I 2I Land & Legal Land .a jcede I Use Description Zoning I Front I Depth - Category I Land Units I Land Value LN Legal Description 1 11000 COMMERCIAL ACG 1 0.00 0.00 1 Common i 71,874.00 1 $1,796,131.00 1 1 5 -69 21 -2S -29E 1.65 2 I ATLANTIC BEACH 3 1 LOTS 7 TO 18,PT LOT 19 RECD 4 1 O/R 14858 -1893 BLK 1 Buildings Building 1 Building 1 Site Address 363 ATLANTIC BLVD Element I Code I I Detail __..__. Atlantic Beach FL 32233 Exterior Wall f 17 17 C.B. Stucco Roofing Structure 14 14 Wood Truss Building Type 1 1602 - SHOP CTR NBHD Roofing Cover 1 4 4 Built Up or T & G 1 Year Buik i 1990 Interior Wall • 5 1 5 Drywall Int Flooring 1 14 , 14 Carpet I zsz TM 1 Gross Area 1 Heated Area Flooring 15 ! 15 Quarry /Hard Tile 1 50 BAS 50 1 In t Floorin 4 1, 4 Electric I Base Area 1 13100 13100 Heating Fuel ( Canopy - 1572 I 0 Heating Type 14 i 4 Forced- Ducted Total 1 14672 1 13100 Air Conditioning 1 3 3 Central • Ceiling Wall Finish 1 5 !: 5 1 Cell Wall Fin 1 1 2 i ......_ Element I fi Stories ■ 1.000 1 Bedrooms 11.000 I Baths ( 39.000 Rooms / Units 1 20.000 Avg Story Height 1, 12.000 Building 2 Building 2 Site Address -- - - -- __ no building address found -- Element 1 Coda 1 Detail Exterior Wall 1 17 :I 17 C.B. Stucco ' 74 • Building Type 2102 RESTAURANT CLASS II Roofing Structure 14 1 4 Wood Truss ' Year Bulk 1990 Roofing Cover 112 12 Modular Metal 1 Interior Wall I (S I 5 Drywall TY1Ra 1 Gross Area I Heated Are. Interior Wall 8 8 Decorative Cover es Base Area i 4990 4990 Int Flooring , 11 ` I1Ceramlc Clay Tile I BAS s0 Finished Encl Porch 1 652 Int Flooring •JI 0 g 1 12 1 12 Hardwood Canopy 1 70 0 Heating Fuel ; 4 1 4 Electric (i 21 Canopy 266 0 Heating Type 14 • 1 4 Forced - Ducted 1 a 5 L Addition 1 160 ( 160 Air Conditioning 1 3 ( 3 Central 1___2_____ -11 Total 6138 ( silo I um r FEP il_�1fJ Element i Code • Stories 1 1.000 • Bedrooms j 0.000 • Baths ; 19.000 • • Rooms / Units '.. 4.000 Avg Story Height ( 19.000 • • Building 3 Building 3 Site Address Detail ._- ..- ....._ __., -- no building address found -- Element Code 1 ■ Exterior Wall 1 17 1 17 C.B. Stucco Building Type 1 2302 BANK BRANCH Roofing Structure 14 i 4 Wood Truss si 2 i ■ Year Built 1 1990 Roofing Cover i 12 ' 12 Modular Metal Interior Wall 1 5 5 Drywall TIP/ i Fleeted Grose Area 1 Area Int Flooring i 14 14 Carpet Base Area 1 3050 3050 Int Flooring 1 15 15 Quarry/Hard Tile 5 BAS so 0411 so j Canopy ' 366 p Heating Fuel 1 4 ' :l 4 Electric Canopy 1 1000 : 0 Heating Type i 4 14 Forced - Ducted Total ;4416 3050 Air Conditioning 1 3 ! 3 Central Ceiling Wall Finish 1 5 t 5 S Cell Wall Fin 20 "' — s 6 1 2 Element Code Stories 11.000 1 Bedrooms 1 0.000 i Baths t 9.000 ' • Rooms / Units -' 10.000 1 Avg Story Height 1 12.000 , 1 :1= r„ City of 4t(n6e Beac4 r , DOG FRIENDLY RESTAURANT PERMIT APPLICATION (Per Ordinance No. 95-10 -102) oI Or AUTHORIZED AGENT AFFIDAVIT NAME OF ESTABLISHMENT Poes T/t v , a y n FL DHR # S LIQ 12482- rl 1b.vek1 1 AUTFIORIZED AGENTS NAME (PRINTED) is hereby authorized to ACT ON BEHALF OF S hop0e5 c t Sh Luc, , the owner(s) of those lands described within PROPERTY OWNER'S NAME (PRINTED) the attached application, and as described in the attached deed or other such proof of ownership as may be required by the City of Atlantic Beach, Florida in applying for a DOG FRIENDLY RESTAURANT PERMIT. B y SIGNATURE O OPER OWNER Sh s . , s o(- 5 t_LC., - Ge.orcs_. Cron9lUda IS PRINTE AME OF PRO ERIYOWNER SFA E OF COUNTY 01 Signed and sworn before me on this l0 r\ day of Q C 4- 0 b r , 20 By Identification verified: Oath sworn: Yes No T ARY S IGNATURE Notary Public My Commission expires: i'7' Kathleen Marks 14-1 ..... _ • •f Massachusetts l , My Commission Expires on Jan. 26, 2018 DOG _v2011.01 S� t : y 1tw - d : � L.�.i.E� fii. .�ir , s ":3• .nt\ + .L, . :S . \. ..Z'. . 5.� .. Cy,: �'`� � '`: i ? ' DATE r.. ., ,t ,:fi MW c : t:t ti DD 'TAI � t:��, ..:, ... .... , :.,., :..... -,4 � �; :. ,.r;` ::£: •,r <:N ; P oo l . s.,. s:.;5 \:c >.? ,', ;,,'. ,...�;: , 't THIS BINDER IS A TEMPORARY INSURANCE CONTRA T ' ' "_: 8/10/11 ` c C , SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM. PRODUCER 1pek Exi): 843 - 881 -2229 COMPANY BINDER 911 C "_'Ex) 84T H —~—"—"" Travelers Insurance MCKay, Stelling a Associates DATE EfR1 TIME D AT E ERPRfXTE7R' TIME P.O. Box 688 X AM Izwl AM Mt Pleasant, 8C 29465 08/04/11 12:01 PM 09/30/11 NOON Rath D. McKa CODE: �• 8UB CODE: ._._. X PER EXPIRING S ISSUED H EXTEND COVERAGE IN THE ABOVE NAMED COMPANY CUSTOMER ID: POEST -1 DESCRIPTION OF OPERATIONSNEHICLES/PROPERTY (Including Location) INSURED Family Style Restaurant with Liquor Sales Doers Tavern -lax Beach LLC and live entertainment. Property coverage 363 Atlantic Blvd effective 08/04. Liability, WC 08/01/2011 Atlantic Beach FL 32233 QV*`Q S: W W i R -ors: �,,.,. i . •h ... ....n •4: : i'5: PROPERTY - TYPE AND LOCATION OF PROPERTY :'.,._ ,t::. • .: +a<>•:>;::...:,rv:;.;;.::z' ?; "dud deductible er poor oacurre vo /guax• dedu•tib COVERAGE/PERILS/FORMS AMOUNT DEDUCTIBLE COINS % . ea per .__.. _._ 250000 5000 so 1 BETTERMENTS occurrence. CONTENTS 100000 5000 80 LIABILITY COVERAGEIFORMS EACH OCCURRENCE AGGREGATE SCHEDULED FORM © COMPREHENSIVE FORM BODILY INJURY $ 8 '''` i PREMLSESIOPERATIQNS rou owned and Hired auto PROPERTY DAMAGE 8 • � A. ig PRODUCTS/COMPLETEDOPERATIONS Liquor Liability BIaPOCOMBINED $ 1000000 $ 2000000 ,. CONTRACTUAL PER PERSON $ 5000 w- X OTHER: M � j ITI MEDICAL PAYMENTS - ....."- "___,_, _ _ PER ACCIDENT 8 X MEDICAL PAYMENTS PERSONAL INJURY $ A P ER SO L LII JITRY FORM: (1 A 1�1 B Plc 1000000 $ COMBINED SINGLE LIMIT $ 1000000 ANY AUTO —° — — _ Ill BODILY INJURY (Par parson) $ AU. OWNED AUTOS BODILY INJURY Per accIdeM) $ Ei SCHEDULED AUTOS PROPERTY DAMAGE $ MI FIRED AUTO$ MEDICAL PAYMENTS $ NON-OWNED AUTOS PERSONAL INJURY PROT $ .GARAGE LIABILITY UNINSURED MOTORIST $ AUTO PHYSICAL DAMAGE 8 DEDUCTIBLE J ALL VEHICLES 1 �.. J SCHEDULED VEHICLES ACTUAL CASH VALUE COU.ISION: -- STATED AMOUNT $ OTHER THAN COL ^ — EXCESS LIABILITY OTHER EACH OCCURRENCE $ 1000000 X UMBRELLA FORM AGGREGATE 8 2000000 O114ER THAN UMBRELLA FORM SELF•INSUREDRETENTION 8 5000 -•�` _ X I STATUTORY LIMITS _ WORKER'S COMPENSATION EACH ACCIDENT ~ ' ' ND 8 500000 EMPLOYER'S LIABILITY DISEASE • POLICY LIMIT $ 500000 DISEASE • EACH EMPLOYEE $ 500000 Ecu►L General Liablity /Liquor written by Travelers Insurance Company oN0moN91 Workers Compensaioa written by Hartford Insurance Company sb RAGE$ Landlord as additional insured. E'. S MORTGAGEE X \ ADDITIONAL INSURED LOSS PAYEE X Property Manage LOAN 8 Petra Managpement Inc. , Bethany Salcan AUT r EPRE • . - P.O. Sox 330048 Atlantic Beach FL 32233 -0448 • T A ::.Loot . 4. .... , . y:> A4Q... 0 >! , :.... 04/tTA4 I, F, ZI ,RMgg,.:i''.z/,1TTi �zR >,� > .,... .. ,._:... :,........�.ACQR.QOQRB.ORI!1T.1.M.'105.3.V � -AiIr,, , of lt(anfic eeac6i ° DOG FRIENDLY RESTAURANT PERMIT APPLICATION 1 _ J " (Per Ordinance No. 95 -10 -102) DIAGRAM OF DESIGNATED DOG - FRIENDLY OUTDOOR SEATING AREA In the space below, provide a diagram (to scale) of the designated outdoor seating area showing the following: • Boundaries of the designated dog friendly outdoor seating area with dimensions, to scale • Boundaries of any non - designated outdoor seating area with dimensions, to scale • Number and placement of tables, chairs and restaurant equipment • Location of entryways to and exits from all designated and non - designated outdoor areas • Location of all fences and/or barriers • Location of property lines and public rights -of -way, including sidewalks, curbs, common pathways and public improvements, such as benches, fire hydrants, etc 'r Q NAME OF ESTABLISHMENT POCfs TANE.IZJ p� I F" co ' �W FL DHR # S 2491 24-82. 1 s - i u . - -.\ Ste 0 a— 7 i L3 i t___ .. 1 II E Ia / ° '_ , l .. ' , 1 , 0 , . I „‘ '. C) n f S 8 is r_ R` i - ...._._.. iiiiiiiii : � . !■■■■WWII 11 17-i—i! it / : i? . • F, : :- : 7"•! 1 . .. L 111 111 1111 , 3, , ♦. IIIIIIIIIIIII IF 0 J J s Pir a ■ ' 4 1 , I 1 4 I . i:W i ................. W t:411 G� l Inspected & Approved by: 2�/ APPLICATION 1ST QTR 2ND QTR 3RD QTR 4TH QTR APPROVAL INSPECTION INSPECTION INSPECTION INSPECTION DOG_v2011.01 10 i 124 2O I C City af7lt(anticVeacf DOG FRIENDLY RESTAURANT PERMIT APPLICATION .» (Per Ordinance No. 95 -10 -102) PRE - APPLICATION CONSULTATION GENERAL REGULATIONS, COOPERATION, ENFORCEMENT AND PENALTY NAME OF ESTABLISHMENT RE "r�VEgN FL DHR # aok 261 24&. 1. The applicant agrees and confirms that the public food service establishment and the designated `. outdoor area shall comply with all permit conditions and the approved diagram, and that permits shall be conspicuously displayed in the designated outdoor area. [Section 24 158(e)(1); (e)(2)] 2. The applicant agrees and confirms that dogs shall not be permitted to travel through indoor or undesignated outdoor areas of the public food service establishment, and ingress and egress to the designated outdoor area shall not require entrance into or passage through any indoor or undesignated portion of the public food service establishment. [Section 24 158(e)(5); 0(2)c] 3. The applicant agrees and confirms that at all times while the designated outdoor area of the public food service establishment is available to patrons and their dogs, at least one sign shall be posted in a conspicuous and public location near the entrance to the designated outdoor area, the purpose of which shall be to place patrons on notice that the designated outdoor area is currently available to patrons accompanied by their dog or dogs. The mandatory sign shall be printed in an easily legible typeface of not less than thirty -six (36) point font size, and the lettering must be in a contrasting color to the sign background so as to be clearly visible and readable. [Section 24 1580(1)] 4. The applicant agrees and confirms that at least one sign reminding employees of the applicable rules as discussed in this consultation and listed in Section 24- 158(f)(2) shall be posted in a prominent location frequented by employers within the public food service establishment. The mandatory sign shall be printed in an easily legible typeface of not less than thirty -six (36) point font size and the lettering must be in a contrasting color to the sign background so as to be clearly visible and readable. [Section 24 1580(1); 0(2)] 5. The applicant agrees and confirms that at least one sign reminding patrons of the applicable rules as discussed in this consultation and listed in Section 24- 158(f)(3) shall be posted in a prominent location within the designated outdoor area of the public food service establishment. The mandatory sign shall be printed in an easily legible typeface of not less than thirty -six (36) point font size and the lettering must be in a contrasting color to the sign background so as to be clearly visible and readable. [Section 24 1580(1); 0(2)] 6. The applicant agrees and confirms that employees shall wash their hands promptly after touching, petting, or otherwise handling any dog. Employees shall be prohibited from touching, petting, or otherwise handling any dog while serving food or beverages or handling tableware or before entering other parts of the public food service establishment. [Section 24 1580(2) a - b] 7. The applicant agrees and confirms that patrons in a designated outdoor area shall be advised that they should wash their hands before eating. Waterless hand sanitizer shall be provided at all tables in the designated outdoor area. [Section 24 158(e)(3); 0(3)f] 8. The applicant agrees and confirms that employees and patrons shall be instructed that they shall not allow dogs to come into contact with serving dishes, utensils, tableware, linens, paper products, or any other items involved in food service operations. [Section 24 1580(2)d; 0(3)c] DOG_v2011.01 Page 1 of 2 , i o e ,.. City a f t(antic eeac6 DO G FRIENDLY RESTAURANT PERMIT APPLICATION ON °`. r � (Per Ordinance No. 95 -10 -102) :DI3 a''' PRE - APPLICATION CONSULTATION GENERAL REGULATIONS, COOPERATION, ENFORCEMENT AND PENALTY p NAME OF ESTABLISHMENT FOE Aver. \ FL DHR # A �t 24 v� 9. The applicant agrees and confirms that patrons shall be instructed to keep their dogs on a leash and C under reasonable control at all times. Patrons shall not leave their dogs unattended for any period of time. All dogs shall wear a current license tag or rabies tag and the patron shall have a current license or rabies certificate immediately available upon request. [Section 24 158(e)(7); (J)(3)a - b] 10. The applicant agrees and confirms that employees and patrons shall be instructed that dogs shall not be allowed on chairs, tables, or other furnishings. Dogs must remain on the floor /ground level and shall not be permitted in the lap of the patron. [Section 24 158(0(2)e; (f)(3)d] 11. The applicant agrees and confirms that all table and chair surfaces shall be cleaned and sanitized 1 -.49' with an approved product between seating of patrons. Spilled food and drink shall be removed as soon as possible, but in no event less frequently than between seating of patrons at the nearest table. [Section 24 158(f)(2)f - g] 12. The applicant agrees and confirms that employees and patrons shall be instructed that accidents 7 involving dog waste shall be cleaned immediately and the area sanitized with an approved product. A kit with appropriate materials for this purpose shall be kept in the designated outdoor area. Dog waste shall not be carried in or through any indoor portions of the public food service establishment. [Section 24 158(e)(4); (f)(2)h; (f)(3)e] 13. The applicant agrees and confirms that a permit issued pursuant to this part shall not be transferred to a subsequent owner upon the sale or transfer of a public food service establishment, but shall expire automatically upon such sale or transfer. The subsequent owner shall be required to reapply for a permit pursuant to this part if such owner wishes to continue to accommodate patrons' dogs. [Section 24 158(d)(3)h] 14. The applicant agrees and confirms that in accordance with section 509.233(5), Florida Statutes, the Zit-- Community Development Director shall provide the Division of Hotels and Restaurants of the Florida Department of Business and Professional Regulation with a copy of all approved applications issued pursuant to this part. Further, the Community Development Director shall accept and document complaints related to the Dog Friendly Restaurant Program within the City, and shall timely report to the Division of Hotels and Restaurants, all such complaints and City's enforcement response to such complaint. [Section 24 158(g)] 15. The applicant agrees and confirms that failure to comply with the requirements of this pre - application consultation shall be a violation of the Code of Ordinances and shall be subject to any and all enforcement proceedings consistent with the applicable provisions of the Code and general law. [Section 24 158(d)(6)] I verify that I have received a copy of Section 24 -158 of the Atlantic Beach Municipal Code of Ordinances and that I have been counseled by staff regarding my proposed application for participation in the Dog Friendly Restaurant Program. I understand it is my responsibility to ensure all employees and patrons comply with all regulations at all times, and that failure to comply with said regulations may result in the revocation of my Dog Friendly Restaurant Permit. P teirc n. avow I, 9.N. l l APPLIC NT'S SIG A TURE APPLICANT'S PRINTED NAME DATE DOG_v2011.01 Page 2 of 2 of Atiantic &eac4 A ‘'‘ DOG FRIENDLY RESTAURANT INSPECTION CHECKLIST (Per Ordinance No. 95 -10 -102) AB PERMIT # DOG 11- 00100060 NAME OF ESTABLISHMENT POE'S TAVERN FL DBPR -HR # SEA - 2612482 r INITIAL INSPECTION DATE: 10/13/201 1 IR QUARTERLY INSPECTION 5 1ST QTR (Oct - Dec) 2ND QTR (Jan - Mar) 17 3RD QTR (Apr - Jun) F(4TH QTR (Jul - Sep) ✓ Notice of Application for Dog - Friendly Restaurant Permit is conspicuously posted in the proposed designated outdoor area. (Initial Inspection Only) [Section 24- 158(d)(3)b] Configuration of the designated outdoor area is consistent with the approved diagram. ✓ [Section 24- 158(d)(1)] • Dog- Friendly Restaurant Permit is conspicuously posted in the approved designated outdoor area. (Quarterly Inspections Only) [Section 24- 158(e)(2)] Waterless hand sanitizer is provided on all tables in the designated outdoor area. [Section ✓ 24- 158(e)(3)] Dog waste kit stocked with cleaning and sanitizing supplies is maintained in the designated r outdoor area. [Section 24- 158(e)(4)] Employee- directed content sign(s) is conspicuously posted in an employee area. [Section r 24- 158(f)(2)] Patron - directed content sign(s) is conspicuously posted in the designated outdoor area. r [Section 24- 158(f)(3)] COMMENTS: INSPECTED BY DATE [ Copy of inspection results left on -site with responsible party. r Copy of inspection results mailed to responsible party. DOGinspection_v2011.01 o f Atlant c V eac4 DOG FRIENDLY RESTAURANT INSPECTION CHECKLIST (Per Ordinance No. 95 -10 -102) AB PERMIT # DOG 11-00100060 NAME OF ESTABLISHMENT POE'S TAVERN FL DBPR -HR # SEA- 2612482 V< INITIAL INSPECTION DATE: 10/13/2011 r QUARTERLY INSPECTION r 1ST QTR (Oct - Dec) [— 2ND QTR (Jan - Mar) r 3RD QTR (Apr - Jun) [ 4TH QTR (Jul - Sep) Notice of Application for Dog - Friendly Restaurant Permit is conspicuously posted in the proposed designated outdoor area. (Initial Inspection Only) [Section 24- 158(d)(3)b] Configuration of the designated outdoor area is consistent with the approved diagram. r [Section 24- 158(d)(1)] Dog - Friendly Restaurant Permit is conspicuously posted in the approved designated r outdoor area. (Quarterly Inspections Only) [Section 24- 158(e)(2)] Waterless hand sanitizer is provided on all tables in the designated outdoor area. [Section r 24- 158(e)(3)] Dog waste kit stocked with cleaning and sanitizing supplies is maintained in the designated r outdoor area. [Section 24- 158(e)(4)] Employee- directed content sign(s) is conspicuously posted in an employee area. [Section r 24- 158(0(2)] Patron- directed content sign(s) is conspicuously posted in the designated outdoor area. I— [Section 24- 158(0(3)] COMMENTS: INSPECTED BY DATE r Copy of inspection results left on -site with responsible party. Copy of inspection results mailed to responsible party. DOGinspection_v2011.01 Ci of Atlantic �eack vt W OG FRIENDLY RESTAURANT PERMIT APPLICATION Iv, \ v (Per Ordinance No 95 -10 -102) .......) s DIAGRAM OF DESIGNATED DOG - FRIENDLY OUTDOOR SEATING AREA In the space below, provide a diagram (to scale) of the designated outdoor seating area showing the following: • Boundaries of the designated dog friendly outdoor seating area with dimensions, to scale • Boundaries of any non - designated outdoor seating area with dimensions, to scale • Number and placement of tables, chairs and restaurant equipment • Location of entryways to and exits from all designated and non - designated outdoor areas • Location of all fences and/or barriers • Location of property lines and public rights -of -way, including sidewalks, curbs, common pathways and public improvements, such as benches, fire hydrants, etc NAME OF ESTABLISHMENT f2 o f c 1 5 -"riNVEZO D ' 1 . CO 1 ` "�— ' ) FL DHR # S F A 1 2 4 8 2 24 1 , } .,, g i . u o _ ; { 1 T: t __..... 1 " " ° i _ 1 S - - �� / ii. ii: 1 E r.---i--. : I .n[L_n4;17, nn i : _ n_... 4 _ / - y 111111111111111 ' / \ / \ O , r fi t #: ._%.:{ -"'"*"."".."' \\ , ,...4 . .t 4 Inspected & Approved by: L>(Jz ---' APPLICATION 1ST QTR 2ND QTR 3RD QTR 4TH QTR APPROVAL INSPECTION INSPECTION INSPECTION INSPECTION DOG v2011.01 10 l 17-i 2.0U