SIGN WAIVER 715 Atlantic Boulevard Patel APPLICATION FOR WAIVER FROM
CHAPTER 17, SIGNS AND ADVERTISING STRUCTURES
City of Atlantic Beach • 800 Seminole Road •Atlantic Beach,Florida 32233-5445
Phone: (904)247-5800 • FAX (904)247-5805 • http://www.coab.us
Applications requesting that certain provisions of the sign regulations be waived may be made to the City
Commission in accordance with the following section of the iCode of Ordinances for the City of Atlantic
Beach.
Sec. 17-52. Requests to waive certain terms of this Chapter.
Requests to waive terms of this Chapter may be made upon specific.application to the City Commission, with proper
public notice required, provided that no waiver shall be requested that would allow a Prohibited Sign, or any
otherwise unlawful Sign. The applicant requesting such waiver shall have the burden of demonstrating the need for
the requested waiver, and that the waiver is not in conflict with the Intent of this Chapter. The terms of any waiver to
the provisions of this Chapter shall be established by order of the City Commission.
DATE 0
PROPERTY LOCATION 71C P1^[[,RNz1 kL ZONING DISTRICT
APPLICANT Pt S JL P ct t
TYPE OF SIGN AND METHOD OF CONSTRUCTION (Provide requested height, dimensions, size, materials,
iitumination,and any other information needed to fully describe the type of s`ign(s)proposed.
Mtg., �c�,r •}b fru. I$F-r c- k. S FT Ct c C1114c ()e tt Sl c &eel.
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Applicant is advised that any approval authorizing a waiver from the-City of Atlantic Beach sign regulations
does not constitute approval for the issuance of a Building Permit. A Building Permit for Sign(s),demonstrating
compliance with Section 3108,Florida Building Code,along with required fees is required.
PLEASE PROVIDE ONE SIGNED ORIGINAL OF THIS APPLICATION ALONG WITH THE FOLLOWING REQUIRED
INFORMATION. IF COLOR MATERIALS OR DRAWINGS LARGER THAN 11 BY 17 INCHES ARE SUBMITTED
WITH THIS REQUEST,PLEASE SUBMIT EIGHT(8)COPIES OF THESE ATTACHMENTS.
1. For all Freestanding Signs,include survey or site plan showing location of proposed sign(s),and all dimensions including
height and distance from property lines or right-of-ways. For Wall, Fascia and other types of Signs, include elevation
drawing showing location in relation to adjacent signs,mounting detail and type of illumination,if any.
2. Provide linear frontage of office,business or storefront,or entire building,as appropriate.
3. Statement demonstrating the need for the requested waiver,and that the waiver is not in conflict with the Intent of the
City's sign regulations.
4. Provide completed owner's authorization form if applicant is other than property owner.
I HEREBY CERTIFY T.AT L ► ORMATION PROVIDED WITH THIS APPLICATION IS CORRECT.
SIGNATURE � PRINT NAME A TOL(311.6,i-
ADDRESS
Pn. .ADDRESS AND CONTACT INFORMATION OF PERSON TO RECEIVE ALL CORRESPONDENCE REGARDING THIS
APPLICATION (PLEASE( PRINT))
NAME PT�7L\ AN IN &KA_
MAILING ADDRESS ?•c LAc C-CN1.0R\O N \CA,Y-4 S urt L AZa
PHONE CiO "1(k.. 2c\ FAX 904( Ic2 g2.Q 3 J, E-MAIL /-tJlci`,)w-sz.1 Q lcW w-t'Yi Qi:);1•coin
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LETTER OF AUTHORIZATION
Affidavit
To Whom It May Concern:
This letter authorizes Taylor Sign & Design, InOor their Agents or Subcontractors) to act as
Agent,to secure permits or variances required by the local governing body, and to perform sign
or awning installations,removals, or maintenance at the property located at:
Property Address: —71 S Tt i c. \c1 n r T L 1�cfCl`\ i ,1- ` .3
Company Name: a t.. , FOOD �1 ��L Phone Number: clOy c(Z3 S 1
Name: !-I L CA-7EL_ Title: PRAN pry\r),
Address: ?S-1t6" CFit-\rQ ON l�tiuTl S OVLG_ Z oLk W./LW_ CL_ 32)-51
SIGNA ARE OF PROPERTY OWNER/AGENT
STATE OF 17or,ci0.
COUNTY OF bvvoc..t
Sworn to and subscribed before me this /5' day of /2'7a y , 20 /5 .
Signature of Notary State of I /oi-;a/4
Print or Type Commissioned Name of Notary Public
Personally Known(t-{OR Produced Identification( )
Type of Identification Produced: Commission Expires 3/3o I t
(Notary Stamp or Seal Required)
II/' i KATHERINE FORD Ib��i�
r Ili
Commission # FF 215191
=My-ConrmisslonExpires-_ -------
March 30, 2019
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COMMERCIAL SIGN TECHNOLOGIES I! CONTACT REVISION 1 DRAWING NAME 132 mph wind zone Taylor Sign&Design,Inc.
Siege Certified N 6sI2o•9117 lj Andy Patel !1 N/A , '' requirements asper 2014 and is not to be
Mobil 715 Atlantic BIvd.CDR q reproduced,
andypatel@kwikbpoil.com 1 (
www.TaylorSignCo.comADDRESS
11 it Florida Building Code. dupliicated,ordistributed without
1, DRAWING BY written permission or a
4162 St.Augustine Rd.Jacksonville,FL 32207 Si 715 ATLANTIC BLVD I�
ti Richard Smith i; payment
Taylor &f Design,
Phone:904/396-4652•Fax 904/396-3777 j ATLANTIC BEACH,FL 32233 ii +i
O 2012 Taylor Sign&Design,Inc.
APPROVED BY DATE
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