2321 MAYPORT DOLLAR TREE BTR AP CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD, ATLAN'T'IC BEACH, FL 32233
LOCAL BUSINESS TAX APPLICATION
Section I
APPLICATION TYPE: ®New Business ❑Transfer of Ownership
Transfer to New Location: Previous Location
BUSINESS NAME: 1)Oka-r- ('e e
LOCATION ADDRESS: 6A')C-1
MAILING ADDRESS:5 *\\JD 1-i t'I to 10A 133 Z
BUSINESS PHONE: I at[I 'c�(I D FAX: ��"3d�^Gj�i CELL:
EMAIL ADDRESS:
BUSINESS ENTITY IDENTIFICATION NUMBER: Federal Employer I.D.Number
or
PLEASE EXPLAIN THE NATURE OF THE BUSINESS: Social Security Number
0,A X1 A�.A
SQUARE FOOTAGE OF BUSINESS PREMISES: , C1-: -3 C" U —
(Include both buildings and outside areas used in conjunction with the
Will the following be served? Food: YesgNo
Alcohol: YesIf yes,If restaurant,will dogs be allowed? Yes
Will you have any vending machines? Yes No low:
********************************************************* ***
Section 2
APPLICANT/LOCAL MANAGER/PRINCIPALOFFI ER:_k pu _
HOME ADDRESS: C( , .
HOME PHONE: CELL:
DATE OF BIRTH: ` DRIVERS LICENSE#: P ease attach a copy.)
EMAIL ADDRESS: L3 V-4
STATE LICENSE/CERTIFICATION/REGISTRATION#(if applicable, attach copy):
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Section 3
I, the undersigned,swear that the above statements are true and correct and I agree to notify the City Clerk if there is
any change in the above information.
I further understand that issuance of a Local Business Tax Receipt by the City Clerk in no way relieves me of the
responsibility of compliance with all provisions of the Code of Ordinances pertaining to conducting a business in the
City of Atlantic Beach. Deborah E.Miller
Vice President and Assistant
PRINT NAME: P //Y" C. M, Ile, TITLE: General Counsel/ileal Estate
SIGNATURE Y. _��� DATE
No person, firm or corporation shall engage in or manage any trade, business, profession, or occupation in Atlantic Beach
without first obtaining a Local Business Tax Receipt. Application and/or payment does not constitute approval or issuance of
a receipt.
Walker, Jennifer
From: Escanio, Rey[REscanio@coj.net]
Sent: Tuesday, July 21, 2015 8:39 AM
To: Walker, Jennifer
Cc: Groff, James
Subject: FW: BTR INSPECTION
Attachments: DOLLAR TREE OL.pdf
This occupancy meets the minimum code requirements.
Rey Escanio
CFPE
Fire Safety Inspector
Fire Prevention Division
214 North Hogan, #281
Jacksonville, FL 32202
Phone: (904)255-8561
Fax: (904)2558559
Cell: (904)891-7232
oil
From: Groff, James
Sent: Tuesday, July 21, 2015 8:26 AM
To: Escanio, Rey
Subject: FW: BTR INSPECTION
From: Walker, Jennifer [mailto:jwalker(5)coab us]
Sent: Monday, July 20, 2015 2:40 PM
To: Scott, John
Cc: Groff, James; Arlington, Daniel; Graham, Shirley
Subject: BTR INSPECTION
Good afternoon,
Dollar Tree at 2321 Mayport Rd is ready for their Business Tax Receipt Inspection. I have attached their application with
their contact information.
Thanks,
Jeww� WaUeer
Administrative Assistant
Building Department
1