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Permit Tent 150 Sherry Drive 2012 CITY OF ATLANTIC BEACH. 800 SEMINOLE ROAD y; ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-00000850 Date 7/06/12 Property Address . . . . . . 150 SHERRY DR Tenant nbr, name . . . . . . COMMUNITY PRESBYTERIAN Application type description TENT PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc TEMPORARY TENT 40 X 80 PARKING LOT 7-2 TO 7-9-2012 ---------------------------------------------------------------------------- Owner Contractor COMMUNITY PRESBYTERIAN OWNER CHURCH 150 SHERRY DR " ATLANTIC BEACH FL 322335236 --- ------------------------------------------------------------------------- Permit . . . . . . TENT PERMIT Additional desc TEMPORARY TENT Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/02/13 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 35 . 00 35 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 39 . 00 39 . 00 . 00 . 00 i PERNHT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILI)ING CODES. TN �I b"S 'y �N City of Atlantic Beach • 800 Seminole Road •Atlantic Beach, Florida 32233-5445 Phone (904)247-5800 • Fax (904)247-5845 • http://www.coab.us REGISTRATION FORM FOR TEMPORARY TENTS AND AWNING STRUCTURES Within residential and commercial Zoning Districts, temporary tents and awning structures may be used on private property within the City of Atlantic Beach following submittal of this completed form to the Building and Zoning Department. These may be used only for private temporary events, such as weddings and private parties and may be placed upon the property for a period not to exceed four (4) days or ninety-six (96) hours. DATE l �O APPLICANT NAME: o�dlill-111_ A�bqkV1q1X1 LJ MAILING ADDRESS: v ADDRESS WHERE TEMPORARY TENT OR AWNING WILL BE PLACED (If different from mailing address.) DATES THAT THE TEMPO RY TENTS AND AWNING STRU TUR I WILL BE LOCATED ON THE PROPERTY: lev —through m / TEMPORARY TENTS AND AWNING STRUCTURES SHALL BE FULLY SECURED, AND THE BELOW SIGNATURE ACKNOWLEDGES THAT THE PROPERTY OWNER AND/OR THE COMPANY INSTALLING ANY TENT OR AWNING ASSUMES ALL LIABILITY AND RESPONSIBILITY FOR SUCH. I HEREBY CER AT ALL INFORMATION PROVIDED IS CORRECT. Signature of p operty �_wnor aut ized agent. SIGNATURE PRINT NAME Q-kn g� CONTACT ORMATIO F PERSON SUBMITTING THIS --++REGISTRATION FORM (PLEASE PRINT) NAME 1 °� l: l�K�.'✓ MAILING ADDRES PHONE q� 9Cj3 gdel FAX U E-MAIL ntn(,5h tsS City of Atlantic Beach • 800 Seminole Road •Atlantic Beach, Florida 32233-5445 Phone(904)247-5800• Fax (904)247-5845 • http://www.coab.us REGISTRATION FORM FOR APPROVAL OF TEMPORARY SPECIAL EVENTS All information requested on this form must be fully addressed in order to receive approval from the City of Atlantic Beach to hold any special event by any commercial entity, non-profit, charitable, or for profit organization on private property, which involves activities exceeding normal day-to-day use of property or business operations, the use of outdoor tents, service or cooking facilities, or any expansion of the business area to an outdoor area or any parking area. Use of tents requires an additional tent registration form. In no case shall any such temporary special event extend to utilize any public property, street, sidewalk or right-of-ways. Requests to receive approval for temporary special events should be submitted to the City not less than thirty (30) days prior to the proposed event. DATE BUSINESS AND APPLICANT NAME: 0.6kin t G_?- 0A wi,2� Ls,�--- MAILING ADDRESS: 56 v2 ADDRESS AND LOCATION WHERE EVE T WILL TAKE PLACE (If different from mailing address.) REQUESTED DATE(S)FOR TEMPORARY EVENT `7 f 6 -7& 2 a- THE BELOW SIGNATURE ACKNOWLEDGES THAT THE PROPERTY OWNER AND/OR THE COMPANY CONDUCTING SUCH TEMPORARY EVENT ASSUMES ALL LIABILITY AND RESPONSIBILITY FOR SUCH EVENT. I HEtEBY CX-T,7rty HAT ALL INFORMATION PROVIDED IS CORRECT. Signature of o ner or horized agent. SIGNATURE PRINT NAME JA I CONTACT I ORMATION OF PERSON SUBMITTING THIS REGISTRATION FORM (PLEASE PRINT) NAME l Sf� MAILING ADDRE PHONE � � -�o��FAX E-MAIL Please provide all information as requested on the attached pages. ' Jul 06 12 03: 50p Shelley Speed 904-246-1522 p. 2 LLJCq 0 mi 7m, .J U o CV) LJLJ Z N Z C7) � N0Ci) CC •^ 00%,`�► �, ' Q �o U 0 • d' �C Cyd LLJ 0: Z, E ti:a: : t o 4 M 51. #•r a t W © � :W: Z o L-: U- in C Jul 06 12 03: 50p Shelley Speed 904-246-1522 p. 1 Post-its Fax Note 7671 Date, q pages To D From Co./Dept. �U Co. Phone# Phone# Fax# 1 c, S Fax# 1 r "11t,r C 3 N F C C U � C _ CD ] N +.: N C L Q ' -00 N �7 W � 5 •— E j1 N u 2 +� C a) •L y '�.� N Q? Q O W CLin LL. ac g E m m ° 'a t3 _� •'� N f0 > tU J '> v, o0N c YcD y O �' � y a �[a��.� H 5u- 0 n I LU r. .. 4) Ri ca v w m J cn IY '� .- a� E a m y ,� u L ti 3W O W O N 4- V S C N >1 "0 r .b N E wVr- at 2 0 - 0 = C c c r N ftf m (� G O N M a �- N .�? ca ✓ cCi C4 E a W LO ca a �'O ao d � a) m N w o (D — E, 'aS s 3 z^ _ Z y�iriuro E COro 1- 0 w ' W W U .,�- u�i z G� o c c c 21. Is this a first time event or a continuation of an annual event? 1,57— —fl 11'1 L 22. Were they complaints or problems at prior events of this nature? /.,j 0 23. What additional signage will be used? (Such as for advertising, restrooms, alcohol consumption? (City Sign regulations apply.) 24. How will the event be promoted and advertised (such as through the use of fliers, TV, Radio, etc.) N 25. Acknowledge by signature below that this special event will comply with all City of Atlantic Beach laws and ordinances and that the event will be conducted and managed as represented within this application. Such',acknowledgement extends to all those organizing, planning and staffing this event. SIGNATU DATE PRINT NAME009111-v%- EVENT APPROVED: REQUEST DENIED: SIGNED: r DATE: Department of Public Sa ty SIGNED: DATE:��/�Z Jim H son, ity Manager 3 1. What type of alcohol will be served and how? Beer? Wine? Other? Served inside? Outside? 2. Provide approved copy of any required Alcoholic Beverage Permits from the Division of Alcohol Beverages and Tobacco? (Additional permit required by DABT for any expansion of Licensed Premises.) 0114 3. Identify the event sponsor and provide p�iate contact��son in cas�n�g�Y 141h,lad P 4. Provide a site plan depicting the layout and location activities, including parking and traffic flow p p distribution points, any tents, fences, security check points, and location of planned events and activities. 5. Has the business consulted with neighboring businesses to obtain their approvals? 6. Will i Ithere be outdoor music?oW Will there be amplified outdoor music? What hours? Ca-3 J�ba Aad 7. Will there be a live band? lLN What hours? 8. How many people are expected to attend this event? �60 9. How will crowd control be managed if there is an overflow crowd? 10. What specific special events are planned? (...such as bobbing for apples; ring toss• dunking booths; wet t-shirts; bikini contests; all male/female "review") "l SA J. Al n 11. How will parking be located and manag d? Include site plan showing parking areas to be used for this 2Nd event. 5 , Cc.-�> Cow KIAA 12. How'will security needs be provided; particularly with respect to prohibiting minors from being served. (See following question.) Will off duty police or private security be used? Who is the contact person on- site if problems arise? (Must be approved by City of Atlantic Beach Police Department. �1for- 13. How are they goin/to assure that all people consuming alcohol are old enough? Wrist bands? Door men? 14. Are any tents to be erected on the property? (Tent registration form required.) l 15. Will there be any outdoor heating or cooking? If so, address how any by-products and refuse will be handled, including grease/oil/refuse. How will any extra trash collection and disposal needs, during and afterjthe event, be addressed? 16. Will there be any extension of electricity into the parking areas, outdoor areas or any yards? l fekenzo K 17. Special temporary events cannot negatively impact traffic flows, particularly in any adjacent residential areas, or close or block any public street or right-of-way Please address. �Kj) - 18. Address how fire code requirements and access for emergency vehicle be monitored and maintained at all times during the Special event. N i114' 19. Are there going to be any fires or fireworks? /Q0 20. Other than service animals, are there going to be any animals allowed as part of this special event? 2 Jul 06 12 04: 39p Shelley Speed 904-246-1522 p. l a;e Cl) ' C oovo 10000 1 0 'r7- ''� t IQ �• t � w '�J�P X� � Z 1. ' 1•� � o J, 0 a r ( V c 0 eco v - �i 0 0 0 0 0 m rul. n rA 1D City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road — Atlantic Beach, Florida 32233-5445 Phone(904)247-5626 . Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: 7- City web-site: http:/1www.co9b.us APPLICATION REVIEW AND TRACKING FORMA Property Address: Department review required. Yes No Building Applicant: Planning &Zoning �K..� Tree Administrator Project; Public Works Public Utilities Public Safety Fire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLIC ON STATUS Reviewing Department First Review: Pproved. []Denied. (Circle one.) Comments: BUILDING 9e2 PLANNING&ZONING Reviewed by: Date: TREE ADMIN. Second Review: ❑Approved as revised. ❑Der ied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. []Denied. Comments: Reviewed by: Date: Revised 07=10 r��nn� Y s ��� �?�fi U'� (�1 ' �,�,� �r� �� �'�'� � �.___ ��.�.- `� ,�� � ,