590 Jasmine St CIV20-0001 JFRD 1st submittal comments1 City of Atlantic Beach
Building Department
1 800 Seminole Road
�r Atlantic Beach, Florida 32233-5445
Phone (904) 247-5826 • Fax (904) 247-5845
.Urs E-mail: building-dept@coab.us
City web -site: http://www.coab.us
APPLICATION NUMBER
(To be assigned by the Building Department.)
M V a0_000r
Date routed: _ a. I 1 ar)
APPLICATION REVIEW AND TRACKING FORM
Property Address: l� �usi�s� - Department review
uildi
Applicant: I\ I\ �.11 CA W t C. �-2% tannin &tonin
Tree Administrator
Project: S t � Public oris
ub_rc i t les
WDffit) Public Safet
ire Services
ReviewLfee� _ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
Reviewing Department
(Circle one.)
BUILDING
PLANNING & ZONING
TREE ADMIN.
PUBLIC WORKS
PUBLIC UTILITIES
PUBLIC SAFETY
L,J.IRE SERVICES
Revised 05119120V
Yes I No
—APPLICATION STATUS _
First Review: ❑Approved. Denied_ [-]Not applicable
Comments:
Reviewed by: Date: 2 - Zr ZO2fJ
Second Review: ❑Approved as revised. ❑Den d, ❑Not applicable
Comments:
Third Review:
Comments:
Reviewed by: Date:
❑Approved as revised. []Denied- ❑Not applicable
Reviewed by:
Date:
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Printing :: CR547759
Duval County, City Of Jacksonville
Jim Overton, Tax Collector
231 E. Forsyth Street
Jacksonville. FL 32202
General Collection Receipt
Page 1 of 1
Account No: CR547759 Date: 2/21..2020
User: Dipierri, Miguel Email: DiPicrrN coj.net
FIRE NIARSHALL FEE FOR SERVICES PROVIDED
Name: Connelly & Wicker
Address: 10060-500 Skinner Lake Dr
Description: plan review fee atlantic Bch Civ 20-0001590 Jasmine St
TranCode IndexCode SubObject GLAcct SubsidNe UserCode Project ProjectDti Grant Grantl)d OacNa Amount
701 I FRFP159F1 i 34222 I i I I I I I 12500
Jim Overton, Tax Collector
General Collections Receipt
City of Jacksonville, Duval County
Account No: CR547759FIRE MARSHALL FEE FOR SERVICES PROVIDED
Name: Connelly & Wicker
Address 10060-500 Skinner Lake Dr
Description. plan review fee atlantic Bch Ctv 20-0001590 Jasmine St
httDs://tccr.coi.net/t)rinting.asr)x?cr--CR547759
'total Due: $125.00
Date: 2/21/2020
Total Due: 1125.00
2/21/2020