1021 ATLANTIC BLVD - APPLICATION TO STOCK & TRAIN ioi
800 Seminole Road
' Atlantic Beach, Florida 32233
Telephone (904) 247-5800
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5-fri FAX (904) 247-5845
Application for Permission to Stock and Train (PST)
Date: S — 10 1 (2 Permit#: l b— (-TNT-9 6 1
Name of Business: Pe 6 LA.pp i x Pim
Address of Project: /0 2-1 /4-11,9-n tc c t3 k 1.06; 4-7-14,r,c_Deolot,, 3 2 2 3 ?
Occupancy Type: Property ID No.:
Contractor Info:
Name: rrj1 JL. C°41 ec,c--ttoA License No.: C- 6( 1.... o 3 61
Address: i (f) ee1}f 1 ,..u,v;w►,�k)0)-f Phone:33027.3'22e4Email:IA/(AM.), ed,21J-e$.5 Co.^-1.
Owners (all, partners, CEO, or board members): F>0 ;cA- , / iz 151,,, ,-,_ lac, ( 7/'
1
Address: )L-1O //Led To �� Phone: 81 2('3 mail: t )( (t/2r-9 ei'/•Le"*—t—
Associated permits
Description of PST event/activity / CA-i A ;iii C 4 of t frciai-.1W
Starting date requested /0 ✓JA/t' , (, End date 023 TVLY /(o
Please submit the following items with the Permission to Stock and Train Application.
1. Site plan, indicating areas where stock and train activities will occur and employee on-site parking.
2. Proof of premise Liability Insurance and Worker's Compensation.
Conditions:
1. Building must pass a Building Safety Inspection, from the City Building Inspector.
2. Building must pass a Fire Safety Final Inspection, from the Jacksonville Fire Marshal's Office.
Inspection includes, but not limited to:
- Fire sprinklers and alarm systems complete and approved.
- Emergency lighting functional
- Kitchen fire suppression systems functional and approved.
3. Job fairs and activities involving other than employees of the building contractor and business owner cannot
be included in this PST.
4. Temporary signs should comply with provisions of AB Sign Ordinance or PUD (where applicable)
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5. All merchandise, display, tents, supplies, furniture, etc. shall be placed in such a manner as to not impede
pedestrian or vehicular traffic and shall not impede an exit or fire lane.
6. All areas approved for stock and train shall provide accessible restroom facilities within a reasonable
distance.
7. All employee parking must be on site.
This agreement is not a Certificate of Occupancy. The Certificate of Occupancy must be issued before
opening for business and before the general public can be allowed on site.
The City of Atlantic Beach reserves the right to revoke this agreement and disconnect service utilities if the
above conditions are not adhered to, or unsafe conditions exist.
I HEREBY CERTIFY THAT I UNDERSTAND AND AGREE TO THE ABOVE CONDITIONS, AND ALL INFORMATION IS
CORRECT:
Signed By:
Contractor: /41 Date c---/ U ._ / v
Owners: 4 J Date / (f) J/ b
Approvals:
Building and Zoning Director Date
Fire Marshal Date
Building Official Date
Public Works Date
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