DOGGIE DINING ANNUAL PERMIT 2011 AL'S PIZZA IS-1 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 11-00100062 Date 10/26/11
Property Address . . . . . . 303 ATLANTIC BLVD
Application type description DOG-FRIENDLY DINING APPLICATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
doggie dining expires 9/30/2012
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Owner Contractor
------------------------ ------------------------
JUNK MICHARE OWNER
915 N 13TH STREET
JAX BEACH FL 32250
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Permit . . . . . . DOGS ALLOWED OUTDR FD SERV ARA
Additional desc . .
Permit Fee . . . . 125 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 10/25/12
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Special Notes and Comments
PERMIT MUST BE RENEWED EVERY YEAR AND
IS VALID UNTIL OCTOBER 1 . QUATERLY
INSPECTIONS WILL BE DONE.
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 125 . 00 125 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 125 . 00 125 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
OG FRIENDLY RESTAURANT PERMIT APPLICATION
(Per Ordinance No.95-10-lo2)
AUTHORIZED AGENT AFFIDAVIT
NAME OF ESTABLISHMENTAL'S PIZZA
FL DHR# SEA 2611595
ALMANSUR
AUTHOR12ED--A—G—E—N—T,—S—N—A—M—E—(—pR—INTED)— is hereby authorized to ACT ON BEHALF OF
MICHAEL JUNK ,the owner(s)of those lands described within
PROPERTY 0 FS FNA—ME—(P—R I N—T E�D)
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.
By
SIGNA URE OF PROPERTY 0 R
NTED N E F PROPERTY OWNER
STATE OF
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COUNTYOF
Signed and sworn before me on this
day of j��r
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By
Identification verified:
Oath sworn: Xes No
NOT SIGNATURE
PATRiCK LUIS FOSTEMX Mrnission expires:
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Notar
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my Comm.Expires Nov 9,2014
p"- mmission#'EE 40972
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;OG FRIENDLY RESTAURANT PERMIT APPLICATION
(Per Ordinance No.95-lo-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 thefollowing:
• 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 exitsfrom all designated and non-designated outdoor areas
• Location of allfences andlor 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 ESTABLISHMENTAL'S PIZZA FL DHR# SEA 2611595
Inspected&Approved by:
APPLICATION— 1ST QTR ___2N__D_QTR— 3RD QT7__ 4TH QTR
APPROVAL INSPECTION INSPECTION INSPECTION INSPECTION
OG FRIENDLY RESTAURANT PERMIT APPLICATION
(Per adinance No.95-jo-102)
PRE-APPLICATION CONSULTATION
GENERAL REGULATIONS,COOPERATION,ENFORCEMENT AND PENALTY
NAME OF ESTABLISHMEN-rAL'S PIZZA - FL DHR# SEA 2611595
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);(t)(2)c]
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 24-158(t)(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 24-158(f)(1);(t)(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 24-15809(l);09(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 24-15809(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);09(3)A
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 24-15809(2)d;09(3)c]
UI;U/ A'UMMIC A56,0GO
OG FRIENDLY RESTAURANT
PERMIT APPLICATION
(Per Ordinance No.95-10-102)
PRE-APPLICATION CONSULTATION
GENERAL REGULATIONS,COOPERATION,ENFORCEMENT AND PENALTY
NAME OF ESTABLISHMENTAL'S PIZZA — FL DHR# SEA 2611595
9. The applicant agrees and confirms that patrons shall be instructed to keep their dogs on a leash and
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);09(3)a-b]
10. The applicant agrees and confirms that employees and patrons shall be instructed that dogs shall
and shall not be permitted in the lap of the patron. [Section 24-15809(2)e;(1)(3)d] I I
not be allowed on chairs, tables, or other furnishings. Dogs must remain on the floor/ground eve
11. The applicant agrees and conflrms that all table and chair surfaces shall be cleaned and sanitized
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()9(2)f-g]
12. The applicant agrees and confirms that employees and patrons shall be instructed that accidents
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;09(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)hl
14. The applicant agrees and confirms that in accordance with section 509.233(5),Florida Statutes,the
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
ulations may result in e rev
reg ocation of my Dog Friendly Restaurant Permit.
AL MANSUR la
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APPLICANT'S SIGNATURE APPLICANT'S PRINTED MA-ME DATE
W�N__
;OG FRIENDLY RESTAURANT PERMIT APPLICATION
(Per Ordinance No.95-10-102)
1. FOOD SERVICE ESTABLISHMENT INFORMATION:
NAME OF ESTABLISHMENTAL'S PIZZA FL DHR# SEA 2611595
PROPERTY ADDRESS 303 ATLANTIC BLVD -------------
CITY,STATE,ZIP ATLANTIC BEACH. F1 q99q-q AB BTR # 12-00003412
EMAIL ADDRESS PHONE# 904.249.0002
FAX #904.249.0470
2. APPLICANT INFORMATION:
NAME OF APPLICANT ALMANSUR Submittal-
COMPANY 1�
AL'S PIZZA INC FRequirements
�1 - $�125W
MAILING ADDRESS 303 ATLANTIC BLVD I
ew ee..
CITY,STATE,ZIP ATLANTIC BEACH, FL 32233 IRen a Fee.
EMAIL ADDRESS CompletedPermit UPDATE
AL@ALSPIZZA,COM Application Form
PHONE# 904.249.0002 - FAX # 904.249.0470 Proof of Ownership F
3. PROPERTY OWNER INFORMATION,IF DIFFERENT FROM APPLICANT: Authorized Agent ONFILE
NAME OF OWNER MIKE JUNK Affidavits(if applicable) F
COMPANY — Proof of Insurance
MAILING ADDRESS 915 13TH ST N Diagram of Designated
— Outdoor Dining Area F
CITY,STATE,ZIP JACKSONVILLE BEACH, FL 32250 UPDA
EMAIL ADDRESS
Completed Pre-Application
PHONE# 904.246.2542 FAX # Consultation Form ON FILE F
4. PROOF OF OWNERSHIP: 6. DAYS&HOURS
Please check the box of the applicable document and attach a copy to thisform. DOGS ALLOWED:
F— DUVAL COUNTY PROPERTY RECORD CARD r— DUVAL COUNTY RECORDED DEED SUN 10AM - 1113M
5. PROOF OF INSURANCE: MON 10AM- 11PM
Please provide an original certificate of insurance,or have your agentfax a copy of your certificate providing TUE 10AM- 11PM
commercial general liability insurance in the amount of five hundred thousand dollars ($500,000.00) per WED 10AM - 11PM
occurrence and one million dollars ($1,000,000.00) aggregate. The policy shall not have exclusionsfor
animal bites. All insurance shall befrom companies duly authorized to do business in the State of Florida. F THU 10AM- 111310
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 F FRI 10AM- 12AM
Road,Atlantic Beach,FL 32233)must be listed as a certificate holder. r— SAT 10AM- 12AM
I HAVE READ THE INFORMATION IN THIS APPLICATION AND UNDER PENALTIES OF
PERJURY,I DECLARE TH THE FACTS STATED IN THIS APPLICATION ARE TRUE.
X
_ Z7 ALMANSUR
APPLICANT'S SIGNATURE
APPLICANT'S PRINTED NAME DATE
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Above is a diagram of the outside patio of Al's Pizza located at 303 Atlantic Blvd, d
Atlantic Beach, FL, 32233. This is the proposed area for a designated outdoor dining
area for dogs to be allowed. 'fhe patio is open on three sides. One of two entrances into
Al's Pizza is located in the center of the patio. Just to the left of the entrance on the patio
wt will display notification that the patio is pet ffiendly and the approved required rules
for this to be a pet friendly dining are. There are 6 tables with 4 chairs each on the patio.
Alls Pizza Efflp-lovee POlicv cOncerningdoes.-
Employees must wash their hands promptly after touching, petting, or
otherwise handling any dog.
Employees are prohibited from touching, petting, or otherwise handling
any dog while serving food or beverages or handling tableware or
before entering other parts of the restaurant.
Employees must advise Patrons in designated outdoor area to wash
their hands before eating; waterless hand sanitizer is also provided for
convenience at all tables in designated outdoor area.
Employees and patrons must not allow any part of a dog to be on chairs,
tables, or other furnishing.
Employees must clean and sanitize all table and chair surfaces with an
approved product between seating of patrons.
Employees must remove all dropped food and spilled drink from the
floor or ground as soon as possible but in no event less frequently than
between seating of patrons at nearest table.
Employees and patrons must remove all dog waste immediately and the
floor or ground must be immediately cleaned and sanitized with an
approved product.
Dogs may not be in, or travel through, indoor or non-designated
portions of the Al's Pizza
A dog waste kit is located in the center of the Patio just to the left of the
entry door inside a cubical stand. The clean up kit consists of Grab Bags
for solid waste disposal, Spill Be Gone for liquid absorption, Nature's
Miracle for stain and odor remover, and Stay at Home waste disposal
wipes. Along with the dog waste kit there is waterless hand sanitizer for
each of the tables.
Rules for Designated Patio Area for Dogs
Employees must was their hands promptly after touching, petting, or otherwise
handling any dog.
Employees are prohibited from touching,petting, or otherwise handling any dog
while serving food or beverages or handling tableware or before entering other
parts of the restaurant.
Patrons in designated outdoor area are advised to wash their hands before eating;
waterless hand sanitizer is provided for convenience at all tables in designated
outdoor area.
Patrons must keep their dogs under control and on a leash at all times, as also
required by Chapter of the City of Atlantic Beach Municipal Code.
Employees and patrons must not allow any part of a dog to be on chairs,tables, or
other furnishing.
Employees must clean and sanitize all table and chair surfaces with an approved
product between seating of patrons.
Employees must remove all dropped food and spilled drink from the floor or
ground as soon as possible but in no event less frequently than between seating of
patrons at nearest table.
Employees and patrons must remove all dog waste immediately and the floor or
ground must be immediately cleaned and sanitized with an approved product.
Dogs may not be in, or travel through,indoor or non-designated portions of the Al's
Pizza
Employees and patrons will not allow any dog to be in the designated outdoor areas
of the Al's Pizza if Al's Pizza is in violation of any of the requirements of this
ordinance.