272 3rd St - DEMO20-0011 (2) _ City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road D oM o a 0 _ 00 I J
Atlantic Beach, Florida 32233-5445
a
Phone(904)247-5826 • Fax(904)247-5845 T
� E-mail: it in - Date routed: Z I�3 I( bI b
a . bud g dept@coati us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: )-d- 3` S • Department review required Yes No
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Applicant: ^k-' i'0091.4- QSTl:
- _u 11-�j, Planning &Zoning
Tr Administrator
Project: ('il.Q-,.c 0 \)043.- ublic Works
Public 'tilities
Public Safety __
Fire Services
Review fee $ Dept Signature 4 c�'r
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept.of Transportation ` (7
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants ./.)C /
Division of Alcoholic Beverages and Tobacco Vq�\
Other:
APPLICATION STATUS
Reviewing Department First Review: 14Proved. I 'Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING U -C S4 rvc-/v✓—Q On -reAr.4 -0--6-1/-,
PLANNING &ZONING Reviewed by: Date: �' Y.0-0
TREE ADMIN. Second Review:
❑Approved as revised. ❑Deni Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. ['Denied. I 'Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017