HomeMy WebLinkAboutCLE201700245 Application 2017-11-020Clearance
Application foVITMc5
CLE #
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OFFICE USE ONLY.
PLEASE REVIEW ALL 3 SHEETS
Check # Date: I 0 ' 1
Receipt # ( I Staff.2[ �(
PARCEL INFORMATION
Tax Map and Parcel: 07800-00-00-03110 Existing Zoning Planned Development Mixed G
Parcel Owner: Martha Jefferson Hospital
Parcel Address: 595 Martha Jefferson Drive, Suite 100 City Charlottesville State VA Zip 22903
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Brad Simpson
Address : 455 2nd Street, SE, Suite 301 City Charlottesville State VA Zip 22903
Office Phone: (434) 974-9890 Cell # 434-906-0972 Fax # E-mail bradsi@acac.com
APPLICANT INFORMATION ACAC Fitness & Wellness & Physical Therapy @ ACAC
Check any that apply: Change of ownership Change of use Change of name X New business
Business Name/Type: ACAC Pantops & Physical Therapy @ ACAC
Previous Business on this site Martha Jefferson Hospital
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
vehicles, and any additional information that you can provide:
ACAC F=mtnQFs & Wellposs Geptar- 4-6 Employees, opep 24 hours. RhysiGal Therapy @ AGAC - 8 Employees, 6;30arn
_ 7- lnm
*This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use to a new location, a new Zoning
Clearance will be required.
I hereby certify that I own or have the owner's permission to use the space indicated on this application. I also certify that the information provided
is true and acc to he best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed "s
APPROVAL INFORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] l3ackflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, x117.
[ZT.4o physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date.
Notes:
Building Officia Date
Zoning Official—fL Date t
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
Revised 11/02/2015 Page 2 of 3
Intake to complete the following:
Y/N
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y/N
Wi e be food preparation?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applies
Is parcel on private well o blic water
If private well, provide Health Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applie
Is parcel on septic o public sewer.
n
Y N
ill you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y/N
11 there be any new construction or renovations?
If so, obtain the proper Permit.
Permit # '62-011- q;)—
CIO 11ltwg
-
ZoninLa to complete the following:
Reviewer to complete the following:
Square footage of Use: 15,00
(Ye2lifted
as: iUfMlwviI 0Rltyyyf IC61
Under Section: 13, 2.• I (z)
Supplementary regulations section: `v
Parking formula: aS r 514c
Required spaces:
aS
Y/N
Ite o be verified in the field:
Inspector Date:
Notes:
Vio ions:
Y/
Ifs ist:
:
Y
PMi's't:
If
a 'ance:
WY N
o, List:
SP'
Y/N
If ist:
Clearances:
l U 0
SDP's
2002
20o7-1s 6
10071 �I
1006 - 171 S 1
2 boa.
'200 ► ' 70
Revised 11/I/2015 Page 3 of 3
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
I certify that notice of the application, i�vppb, c�,y gpn, cLea--, , c.r-
[County application name and mber]
was provided to _�� �ti o ,6L the owner of record of Tax Map
[name(s) of the reMYd owners of the parcel]
and Parcel Number `7 ICJ o - o'� -� - 3 I I O by delivering a copy of the application in the
manner identified below:
QHand delivering a copy of the application to
[Name of the record owner if the record owner is a
person; if the owner of record is an entity, identify the recipient of the record and the recipient's
title or office for that entity]
on
Date
Mailing a copy of the application toCM
[Name of the recoi owner if the re ord owner is a person;
if the owner of record is an entity, identify the recipient of the record and the recipient's title or
office for that entity]
on 1 0- 9 1— 1-7 to the following address:
Date
�n ZC Q6, C4-a,10 9,p Yd1-c, 1/4 zZS0 a
[address; written notice mailed to the owner at the last known address of the owner as shown on
the current real estate tax assessment books or current real estate tax assessment records satisfies
this requirement].
n��
Si ture of Applicant
Print Applicant 14ame
)(3_ 1-1
Date
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FITNESS AREA
— t 101 1102G SF
3'-1,
STORAGE 1 1 DF 1
105 186 SF
OFFICE
ALIGN ® 103172 SF
I I I 9-3 1' 1
I
GROUPER/
OFFICE
TRAINING t TO217]sF ti
STUDIO
H.5 — _ 1D4T930SF
/ I
H.7
A402 3 e 3 P
1
eve 1r' RECEPTION
300 1 202 5F
2 PROPOSED FLOOR PLAN
A101 SCALE _
NOTE: MILLWORK IS TO BE PROVIDED AND INSTALLED BY
OWNER'S MILLWORK CONTRACTOR; G.C. TO COORDINATE
W/ OWNER'S SUB
PROPOSED KEYED NOTES
DEMOLITION KEYED NOTES
ed
DESIGN
zo W OBLOCKING IN WALLS FOR TR%%A40L'NTS. RE -ENFORCE EXIST DEMISING WAIL
RT CO
T KAR A I TIN PA TITIONS COOKS FRAMES FLOOR=F
Ol U.O.N. THROU6NOU WOF E REMOVE llE%5 G R
a
COLLABORATION
W/431r11l METAL STUDS OF EgUIVALENT SIff TO E%IST STUDS, V.I.f; SECURE TO UNDERSIDE OF
W/43MI
STRUCTURE ABOVE. REPLACE EXIST GWB W/NEW 5/8"GWB.
FINIS!3E5, PLUMBING FIXTURES, MILIW'ORK, FUFNISHINGS,E%IT SIGNS, DRYWALLANDDAMAGEDINNOVATION
ACOUSTICAL CEILING TILE, LIGHTING, BNVACREGISTER. CAP PLUMBING BEHIND WALLS OR BELOW
ARCHITECTS
SLAB. REMOVE ALL ABANDONED OR LOOSE WIRES, CONDUITS AND/OR PIPING ABOVE EXISTING
21 REFRIGERATOR FOR COLD TOWELS: OWNER PROVIDED, GC INSTALLED.
CEILING, RAISE EXISTING SPRINKLER SYSTEM FOR FUTURE USE IN NEW CEILING, TYPICAL.
22 NEW CUSTOM OI•ER512ED WOOD POCKET DOOR
02 EXISTIN G WALL TO BE DEMOLISHED
• ,s,00 wReJc xEADo,Y60F
• GE3RM4NTJWrv, x02e10i4
/
• lPlm,soeo44s
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23 NEW PARTIAL HEIGHT \VALE T.O. WAIL . S'-0" AFF. MIRRORS ON ..-SIDES.
03 EXISTING ELECTRICAL PANEL TO BE RELOCATED, PARTIAL WALL BEHIND PANEL TO BE DEMOLISHED.
• Nwry GCMRCHLXM3
—
24 RELOCATE EXIST SANITARY PIPE TO 5ECORNER OF EX61 COLUMN D/4.;REFPLUMBINGDWGS
OS REMOVE EXISTING DOOR AND FRAME; PATCH WALL AND PREPARE TO RECEIVE NEW FINISH.
myN
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25 NEW STOREFRONT GLAZING SYSTEM
OS PARTIALLY REMOVE EXISTING WALL FOR NEW DOOR INSTALLATION
LEGACY MANAGEMENT
GROUP, INC.
26 IYP.COAT RACKATOPENGYM TREATMENT TABLES! V-4'L1x4 (PAINTED PT-2j MOUNTED @5'-5'.
05 EXISTINGSTORM DRAINTOBE RELOCATED. REFERTO PROPOSED PLAN FOR LOCATION.
4552NDSTREETSE
—'� —
A.F.F. ITOTOP);G.C. TO PROVIDE FRTWD BLOCKING IN WALL. (2) COATHOOKSTOBE MOUNTEOTO
1x4@1'-0"O.C.;
07 EXISTING PIPE TO REMAIN.
SURE.1
C LOtiESVIUE, VA 2-2
27 STACKED WASHEF/DRYE R UN IT; REF PLUMBING DWGS; OWN ER-SU PFUED, CONTRACTOR -INSTALLED
09 EXISTING DOOR TO REMAIN.
IP) 4N 97L9B90
26 RELOCATED SANITARY PIPE. REF PLUMB DWGS.
09 EXISTING SANITARY PIPE TO BE RELOCATED. REFER TO PROPOSED PLAN FOR NEW LOCATION.
29 HOLD COLD M N FURFI NG TIGHT TO COLUMN.
10 REMOVE EXISTING CONCRETE SIAS. COORDINATE EXTENT OF SLAB DEMOLITION WITH PROPOSED
j
30 LOCKERS, TYF OF];OY(NER-SUPPLIED, CONTRACTOR INSTALLED
PLAN.
31 MIRRORED WAll:4'0"W%8'-C"H-MOUNT DIRECTLY ABOVE 4'WALL &15E
PLAN LEGEND
mACNANIuyKeKcmluyvTumelHC Koexueran
32 MIRRORED WALL.W-OWXT-O'H- MOUNT DIRECTLY ABOVE 4'WA!L BASE
THOMASFOULKES,LLC
HE PARKAVENUE
b)41B26E-I1K)6 1)
/
33 BARITE ASSEMBLY THIS WALL W/MIRROR ABOVE AND BELOW
EXIST. WAIL/PARTITION
(PI41PE62-1&16
34 flXOSYSTEM-CENTERON FORCE METAL STUD D
PROVIDE )ROWSOF 2 SURFACEFRTWO D PERELEVATION DETAIL; &
URFAC MOUNTED
IIRjj'''\ &DOOR TO REMAIN
\ /PARTMON
COORDINATE OVERALL LENGTH OF WOOD BLOCKING W/ IRK BRACKET SIZE,
CNEWWALL
NEW DOOR
WALL/ PARTITION OR
DOOR TO BE
IN LL
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DEMOUSHED
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FINISH SCHEDULE
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