429 SKATE RD - 17-ROOF-3550 ?tui1'/r, City of Atlantic Beach APPLICATION NUMBER
ys *�i-`
� l Building Department (To be assigned by the Building Department.)
v 800 Seminole Road CC
7 •F,1Atlantic Beach, Florida 32233-5445 7 —R ooF - J
Phone(904)247-5826 • Fax(904)247-5845
....an �? Email: building dept@coab.us Date routed: `, Z Z l i7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 4 Z° S KR'TE R JTh De ment review required Yes No
Building
Applicant: PI (_P a\ E,N.D 7 Ro o P t k_)q anning &Zoning
Tree Administrator
Project: R E , z.0 o F ,o Dir—( E.C Public Works
Public Utilities
Public Safety _
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By ,,,---__
Florida Dept. of Environmental Protection ---....
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Re -
Division of Alcoholic Beve67/l it ado& I-0 pie `P
Other: / / r /
et th
Reviewing Department First Review
0
4 -011 S Pal <
(Circle one.) Comments: _/ / /--�
UUC(iv►��rt� �"
BUILDINGa / ,r a J V �'-e 1 ff ei
nk PLANNING &ZONING kQ P S,
�� Q AN Date: -
TREE ADMIN. nn JSecond ReviE
PUBLIC WORKS Comments: 31 2f/( ) /y
PUBLIC UTILITIES ',/71
PUBLIC SAFETY Reviewed by: Date.
FIRE SERVICES Third Review: ❑Approved as revised. (Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09