Loading...
1898 Selva Marina Dr DWAY19-0055 Concrete 1'y',sri,,, DRIVEWAY PERMIT PERMIT NUMBER �; CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD DWAY19-0055 / ISSUED: 1/16/2020 I . � / ;��o' ?"—v ATLANTIC BEACH. FL 32233 EXPIRES: 7/14/2020 MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES . ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY. NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. ., ;`' JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK: DRIVEWAY SINGLE OR TWO 1898 SELVA MARINA DR FAMILY DRIVEWAY CONCRETE DRIVEWAY $8000.00 TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 169462 0125 SEVILLA GARDENS UNIT 01 COMPANY: i ADDRESS: CITY: STATE: ZIP: Beaches Masonry & 1724 Penman Rd Jacksonville Beach FL 32250 Concrete OWNER: ADDRESS: CITY: STATE: ZIP: MCCARTHY DANIEL 1898 SELVA MARINA DR ATLANTIC BEACH FL 32233-5620 WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. LIST OF CONDITIONS Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. 1 PUBLIC WORKS DRIVFWAY APRON INFORMATIONAL Notes: All concrete driveway aprons must be 5 inches thick,4000 psi,with fibermesh from edge of pavement to the property line.Reinforcing rods or mesh are not allowed in the City right-of-way. Issued Date: 1/16/2020 1 of 2 %,'//,, DRIVEWAY PERMIT PERMIT NUMBER J .: CITY OF ATLANTIC BEACH DWAY19-0055 800 SEMINOLE ROAD ISSUED: 1/16/2020 Ji3 �� y ATLANTIC BEACH. FL 32233 EXPIRES: 7/14/2020 2 PUBLIC WORKS EROSION CONTROL INSTALLATION INFORMATIONAL Notes: Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line(904-247 -5814)to request an Erosion and Sediment Control Inspection prior to start of construction. 3 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during construction. 4 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL Notes: Roll off container company must be on City approved list. Approved list can be obtained at the Building Department at City Hall. Roll off container cannot be placed on City right-of-way. 5 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL ' Notes: Full right-of-way restoration,including sod,is required. 6 PUBLIC WORKS RUNOFF INFORMATIONAL Notes: All runoff must remain on-site. Cannot raise lot elevation. 7 PUBLIC WORKS MAXIMUM DRIVEWAY INFORMATIONAL Notes: Maximum driveway width within the City right-of-way is 20 feet. FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00 ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $100.00 TOTAL:$125.00 Issued Date: 1/16/2020 2 of 2 01.:1 a;., City of Atlantic Beach APPLICATION NUMBER E'•t* Building Department (To be assigned by the Building Department.) A 800 Seminole Road "I.JU�� Di,()fk(1 j. ,. r Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: I z© t C�1 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM r p, Property Address: I � C'.1V0.fR�'(,�� Department review required Yes No Building Applicant: )- e ,C PAC; S O n r clannmg &Zoning (( c-)rkkretADc, Tree.AdtratdrmmisProject: �_CD C �<�T Q 0-56b116).- r- 7 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 S; St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco .V\') Other: APPLICATION STATUS Reviewing Department First Review: ❑Approved. �/ enied. ❑Not applicable (Circle one.) Comments: BUILDING /11 X Wd PLANNING &ZONING Reviewed by: Date: 1 2 3li-(ct TREE ADMIN. Second Review: Approved as revised. ❑Denied. ONot applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 ' 'r%•.. Building Permit Application Updated 10/9/18 . City of Atlantic Beach Building Department **ALL INFORMATION `J. ,, 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY ,�'n9IS REQUIRED. Phone: (904) 247-5826 Email: Building-Dept@coab.us LUQ ,1q - O rr Job Address: /X7,67 5iV� A-.1 /7 M. �/r Permit Number: 'l/�4� rte►-lir�L 62 O Rt=-6i.)oiiL term Legal Description /5 oY'2$-2 it . Z1 .5E.14/i� 6u2/&1S IT Ol RE# / J P-4. Valuation of Work(Replacement Cost)$ 3 Heated/Cooled SF Non-Heated/Cooled • Class of Work: jNew Addition ❑Alteration Repair ❑Move Demo ❑Pool ❑Window/Door • Use of existing/proposed` structure(s): OCommercial NiResidential • If an existing structure,is a fire sprinkler system installed?: ❑Yes t1No • Will tree(s) be removed in association with proposed project?,F❑'Yes(must submit separate Tree Removal Permit) o f / Describe in detail the type of work to be performed: ,i T)�tlK "1 I CUG4c1�� l„ p Florida Product Approval# for multiple products use product approval form Property Owner J� Information Name �J Name .t, c�t�t tf I M "tall/1) Address /? $'' / /�l V cit2 City MLA PI ft C ) State A.--- Zip 3223 3 Phone y-g00--ato 6 C) E-Mail J)'7/(/ '/44 4/_?r '(C)'1 Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company t 1—t) ` f C' (14rticwJ (�y�, LlCQualifying Agent �.J'ACK rU Address I'I`2.kif Pe 1/ty�:4 City' a1 6e.c;�i-tax State 41' Zip 3 115 Office Phone ci G Y -L12.{;,- L7�U Job Site Contact Number qo L - 4 Z_L' -2-'7 7- 0 + State Certification/Registration# C./ O( 32 '47_ E-Mail LLctL;L4yi"►A/tf�u,Zt\cu �C61-:".Ute- 5[2�c<'` :Co;44 Architect Name&Phone# Engineer's Name&Phone# Workers Compensation Insurer OR Exempt Er Expiration Date Z 62-1 Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS, WELLS, POOLS, FURNACES, BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management districts,state agencies,or federal agencies. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING.YOUR NOTICE OF COMMENCEMENT. _ ? , , 1 / ---- > is (Signature of er gent) / (Sign ture of Contractor) �i ed and sworn to(graSe)b• e thisCE.�lay of ed and sworn to rof it bef. e thi •.ay of r C_' _ 1 . i, r- �giC(ci, - G , 0 ,b X1•/4a;' r t) `'m? TONT GINDLESPE' +:�4 Al _ �,W-.r as %.„,. MY COMMISSION#GG 3531 • I gna. �- o' o� �a'v,r A•., 70NI GINDLESPERGER (Si� at� : N N. VIP ,' •.�,�`rods EXPIRES:October 6,2023 ::i• i r * „ :*i MY COMMISSION#GG 353178 '• of .°P: Bonded Ttw Notary PubKC Underwriters :• '` EXPIRES:October 6,2023 - - • . . lin is• '•'.'t' er11413deilliKkgiptg f$bilc Underwriters [ )Produced Identification p,�,, ^ C - • • // T Type of Identification: G(60 t —4(J5 S S-I 1 • Ell e of Identification: /V\ 2-DC7 6 -1 7 C7-S Z-203 Jl .) 19 —DOS S NOTICE OF COMMENCEMENT State of //0(7)a\ Tax Folio No. 1 CO 9 4 6, Z v l a S County of V`^.VA., To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes,the following information is stated in tj OTICE O_ F COMMENCE E T. Legal Description of property being improved:y,5—r!2 v — S ^, 91 1 De(417a -.1,1e-/6 L1-4O- 0'.)- Lof `I P7 l_o�y� c cS C,) D/ /2 7.7! 3 .o - Address of property being improved: /7r oV 56.1 “,t_ ,I!77LL)i // <G '� 8e c4 i 322`- S IV General description of improvements: e w CU/ICYC 9J`Vt(itif/ cvOwner: -Gt j/I(d (,Lco,Vfitj Address: Irk✓e'" joy 1 f ? �Selr et Owner's interest in site of the improvement: AiG.nI40.. 17( Fee Simple Titleholder(if other than owner): p)(a'. Name: Contractor: J 611,0 b--tart? p r a- 's *0;04(2, a4p) (2 t C(et UL — Address: ! 2,L1 \ �1ds'!'c�I IS L\$ ) ct 'C ee,cil 22-5° Telephone No.: Cl 3`f 0' b 2720 Fax No: Surety(if any) Address: Amount of Bond$ — Telephone No: Fax No: Name and address of any person making a loan for the construction of the improvements Name: Address: Phone No: Fax No: Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may be served: Name: Address: Telephone No: Fax No: In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b), Florida Statues. (Fill in at Owner's option) Name: Address: Telephone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one (1)year from to is Y"'• ; TONI GINDLESPERGER _ specified): A •.• ws MYCOMMISSION#GG353178 EXPIRES:October 6,2023 THIS SPACE FOR RECORDER'S USE ONLY OWNER �`g'.Fl°` Bonded ThuNotary PabicU Doc#2019291750,OR BK 19046 Page 1830, Signed: _ _ Date: Number Pages: 1 Before me this day' f t z.d in the County of Du I,State g Of Florida,has personal) app red !vc Lai. Recorded 12/23/2019 09:36 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Notary Public at arge,S of FloriC nt of Duval COUNTY My commission expires: C� (� or RECORDING $10.00 Personally Known: Produced Identification: M Z.Cd 3 -1'7 CO ' 4 Z03 - U ty�,y„ Revision Request/Correction to Comments **ALL INFORMATION ,S r HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY IS REQUIRED. " 800 Seminole Rd, Atlantic Beach, FL 32233 ill;ii V Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: DLO Ektl J Z — Oa! ❑ Revision to Issued Permit OR Xorrections to Comments Date: (- ? ZO ZO Project Address: / ZS �j-C /1/G[ ccC + '`/C--' P, v` Contractor/Contact Name: t,e_CLCAte . Milc)i C>orae- (I c'`c'i`'J Contact Phone. o9_u'z(o.-77 Emai . -e�dMc6bn(r c ce & Description of Proposed Revision/Corrections: ['14, 'Pere OA C) `l 049 J� C1 r C' J 4,c)____�,e�I!— -e tb —r-tAa- c , (4 r.� Ori k,U in6 fe vcea�� _cy p/ I , ,, _6„,40 yaffirm the revision/correction to comments is inclusive of the proposed changes. (printed name) _ �� I:7 �a� '--, �vF• Wi proposed revision/corrections add additional square footage to original submitta'l?' A'`-"4 '( L4 L�No ❑ Yes (additional s.f.to be added: ) JAN 9 2020 • \,_lyiyrroposed revision/corrections add additional increase in building value to original submittal? No ❑*Yes (additional increase in building value:$ ) (con ctorniustsi increase nvaluati n) Ullc.4!'lt i...?E�t:)cliti�nt *Signature of Contractor/Agent: ^ City of/';tInnti( [ r.,fich, H, /7 (Office Use Only) Approved ❑ Denied ❑ Not Applicable to Department Permit Fee Due$ Revision/Plan Review Comments Department Review Required: Building anning Zonin 3 Reviewed By —Tree Administrator Lrribiriciir Public Utilities ' ` / 0 'Z (:Ci Public Safety Date Fire Services Updated 10/17/18 rT'°1 r :. TREE Sr VEGETATION AFFIDAVIT FOR INTERNAL OFFICE USE ONLY r z 'k. ?.\ City of Atlantic Beach PERMIT# �ii-. -4 Community Development Department ,�\ 800 Seminole Road Atlantic Beach, FL 32233 -42;09c- (P)904-247-5800 SITE INFORMATION ADDRESS 1 0 gV /\, VOV Nar I Ljf-N_ 1 (-- SUBDIVISION P V C (� Go..(1AV\) BLOCK LOT RE# / ‘ 1 Ll(016 1 - ) X RESIDENTIAL ❑ COMMERCIAL ❑ OTHER APPLICANT INFORMATION r1 NAME t.1 1 4 kfJi C (6t, ] Y l 7 _ PHONE# %k-1 —�V—0)--0() Z6 + J ADDRESS f 7 cQ1/ - Witt0r h,t, Dr. CELL# CITY .-1( j 1 {-'I C.' ):uk STATE (`t ZIP CODE 3223 3 • EMAIL oi4 J(,!"yLw• C.c/V OWNER ❑ LEGAL AUTHORIZED AGENT I affirm that I have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation", of the Municipal Code of Ordinances for the City of Atlantic Beach Florida and/or I have participated in a pre- application meeting with the Administrator of those regulations. Subsequently, I affirm that no regulated trees and no regulated vegetation will be damaged, destroyed and/or removed from the above-described property and/or adjacent properties including right-of-way. I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT:Signature of Property Owner(s)or Authorized Agent .--- --- At/I'd Nqa q:/ //a SIGNATURE OF APPLICANT PRINT OR TYPE NAME / DATE SIGNATURE OF APPLICANT(2) PRINT OR TYPE NAME DATE Signed and sworn before me on this day of _, by State of County of Identification verified: Oath Sworn: ❑ Yes ❑ No Notary Signature My Commission expires 04 TREE AND VEGETATION AFFIDAVIT 03.01.2078 o,:Ly;y City of Atlantic Beach APPLICATION NUMBER ,•s /11,- � Building Department (To be assigned by the Building Department.) 800 Seminole Road I� 1 k, 1 / ] _f�/�, S- J f' Q Atlantic Beach, Florida 32233-5445 1 ` Z/v Phone(904)247-5826 • Fax(904)24r e_ ,5 E-mail: building-dept@coab.us Date routed: ` Z/ Z-oti City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM U Property Address: 1 ,E)cl� Se.lvc-kf\A,armck__ Department review required Yes No Building _ Applicant: e � IV\a S C &Zoning (Thl Tree. minis ratoT Project: �C�NC r� l �r l_J C'LA.D4�� CP-1-6116 Work 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 • t • Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: ❑Approved. Eenied. ['Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed 14d, ;, Date% TREE ADMIN. Second Review: Approved as revised. ❑Denied. ['Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: ' _ Date/ FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. ❑Not applicable Comments: Reviewed by: Date: DEC 2 3 2019 Revised 05/19/2017 .. '`.:. '' -71!, ' ,1 - I f ., .. , Or j?1 trir7 rill a brifrOVV111-7 ,y)/0 e rte r -err' pf:iji, anu-a- , , _ , 4/X0 75whri- 17(7,- 77M ;•7 0- 6tr W4fVPIV r ---4)741)); _ tx TI / /Pr 7:11 TV/ ikii-re 1d7 = fir/X/102' 1l z -/77S1)/ 4 121 !. C i1 A AD# 447---< 1,illz -r4li7 :1774 4#1-4--V--: 0 X X a -07- /Jn_e --4/ 4b'/'J4 -- - - -- -:,�-73", ! "1M- 4/I r#>rT RIGHT-OF-WAY/ EASEMENT PERMIT APPLICATION **ALL INFORMATION 44 **" City of Atlantic Beach HIGHLIGHTED IN GRAY IS 800 Seminole Road, Atlantic Beach, FL 32233 REQUIRED. .x U PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES D WAY 161--0055 ` Job Address ! gsq S`{Lkletr liti Permit Number Contractor Information Companyi.z LS !k,;;4,Qj cod r nr r 2 tZ LL( Qualifying Agent-)5,:a4,_ Cie." 4. Add resst77+{ el, 11444A /2-0 City Stf 4 State, Zip6 Phone ` oti Lj7. - 27"1- e Email i.tAtS �r►1Lsrv,ki:.hC'I. t`344t;,( t rs-2 State Certification/Registration 14 L.,d aj i 3'2_i"? - Architect Phone Email Engineer Phone Email Workers Compensation Insurer OR Exempti t^Expiration Date 24,24 • Permittee declares that prior to filing this application they have ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches. • Whenever necessary for the construction,repair,improvement, maintenance,safe and efficient operation,alteration or relocation of all,or any portion of said street or easement as determined by the Public Works Director,any or all said poles, wires, pipes,cables or other facilities and appurtenances authorized hereunder,shall be immediately removed from said street or easement or reset or relocated hereon as required by the Public Works Director and at the expense of the Permittee unless reimbursement is authorized. • All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the supervision of (Project Superintendent) with(Company Name) Phone • All materials and equipment shall be subject to inspection by the Public Works Director. • All city property shall be restored to its original condition as far as practical,in keeping with City specifications and the manner satisfactory to the City. • A sketch of plans covering details of this installation,as well as a copy of a recent survey shall be made a part of this permit. Calculations showing any increase in impervious area on owner's lot or in the City right-of-way are to be included with this application. • The permittee shall commence actual construction in good faith within days. If the beginning date is more than 60 days from date of permit approval then permittee must review the permit with the Public Works Director to make sure no changes have occurred in the area that would affect the permitted construction. • It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right, title and interest in the land to be entered upon and used by the holder,and the holder will,at all times,assume all risk of and indemnify,defend and save harmless the City of Atlantic Beach from and against any and all loss,damage and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges. • The Public Works Director shall be notified 24 hours prior to starting work and again immediately upon completion. Date id-April/ 7 Permittee(signed in presence ry c) STATE OF FLORIDA,COUNTY OF DUVAL r � 0 The foregoing instrument was acknowledged this �-� day of k�C _ ,20 1 by T cx.r ems` P C t- ► .• - ..: •..-.r-• .-fore me and (printed name of Permittee) v� ? TONI GINDLESPERGER ackn wled d tha = :fled the instrument voluntarily for the purpose`,. . d iro i� Y COMMISSION#GG 353178 EXPIRES:October 6,2023 •'' OR . M1OP` Bonded Ttxu Notary Public Underwi4us [ ]Personally Known Signature of Notary Public,State of F • ida [ ]Produced Identification(Type) �. H:\Applications&Forms\Word&Excel Document Originals\201801001 Right-of-Way Easement Permit Application.docx Revision Date:10/1/18 Revision Request/Correction to Comments **ALL INFORMATION ,s%j#r HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY IS REQUIRED. sl 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:D°"A\I I'°'- 0055 ❑ Revision to Issued Permit OR Xorrections to Comments Date: (• 4''"- 0.0 zv l Project Address: J -9 I-C /t/G[ ki co, i ^iG" ,,, (il--- Contractor/Contact Name: ' eeetC.I'le_c rnmon(fl \'kt.3"Cor C-e- C^ . "-` * J Contact PhonegC)9Z-L 2 — EmaiS-e-as c6 vtekCC,PC-ci d i�a9� " - Description of Proposed Revision/Corrections: ,.. v*qctre O'il tit-'( 01 c lL)-e_o r P - _ - / 2-C° SI( I ) -( affirm the revision/correction to comments is inclusive of the proposed changes. (printed name) Fart- n • VV/proposed revision/corrections add additional square footage to original submittal?'�"-- ''1 —� `\' `^L`—" Li No ❑ Yes (additional s.f.to be added: ) JAN 9 2020 • Wil roposed revision/corrections add additional increase in building value to original submittal? No ❑*Yes (additional increase in building value:$ ) (cont ctor rust s� 'np'f�increa�sle.in valuatip}n) 1 ' r_lu,lcelnc 6er)Cd7 imen *Signature of Contractor/Agent: t" <.;,_ c'f r';':-;r'lf: ";,-,,,,r., H. (Office Use Only) Lt Approved I 1 Denied I I Not Applicable to Department Permit Fee Due$ Revision/Plan Review Comments Department Review Required: /� Building ��W`).s �G '"�°L- anning&Zonln ? r...„,,,,........„ Reviewed By Tree Administratori�wor 5 N 7 3 2020 Public Utilities /- /7'-;20 Public Safety Date Fire Services Updated 10/17/18