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Permit 890 Club Dr kAj1j- CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 r -)IS) - 'f� ��/ Application Number . . . . . 05-00031198 Date 9/27/05 Property Address . . . . . . 890 CLUB DR Tenant nbr, name . . . . . . TELEPHONE CABLE Application description . . . RIGHT OF WAY PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ---------------------- -- ----------------------- - BELL SOUTH TELECOMMUNICATIONS ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . DRIVEWAY PERMIT Additional desc . . Permit Fee . . . . . 00 Plan Check Fee . 00 Issue Date . . . . 9/27/05 Valuation . . . . 0 Expiration Date 3/27/06 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total . 00 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total . 00 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODE& BIJILDINC�OFFICIAL CITY OF ATLANTIC BEACH Nj b PUBLIC UTILITIES DEPARTMENT 1200 Sandpiper Lane Atlantic Beach,Florida 32233 f fn (904)247-5834 (904)247-5843 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # Property Address: _69t) C/ub Dr) Vc" Applicant: Project: Your application is approved as noted by the Public Utilities Department. Final application approval must come from the Building Department. Li Your permit application has been reviewed by the Public Utilities Department and the following items need attention: 1;?9 e--) 1-3 F7�9 C- H 44"QAW&9,pi-2(4p QA 6444rfic- 4L-riL /7—Zdt.0 --E r go n&J)14)447 QU _j� 42&6,�6 65je; CA:4 Please submit these requirements to the Public Utilities Department, 1200 Sandpiper Lane, Atlantic Beach, FL 32233 in order that we can approve your application. If you have any questions,please call (904) 247-5834. RevrDonna lak,Public Utilities Director /2� Kaluzin Sign�ature— .10- Date Contractor Notified Date fax-d 14;.9 31ON 3S —all Z" k ol 7-7 MA im Al Iva, AZ_;� CITY OF ATLANTIC BEACH SIN CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS 904-247-5800 800 Seminole Road SUP . Atlantic Beach,Florida 32233-5445 Fax 904-247-5845 -119 Date r PERMIT* ISSUED BY THE CITY Job Address C) Permitee: BELLSOUTH TELECOMMUNICATIONS Telephone# 904-6341661 Permittee Address: 11AA1, 301 W. BAY ST., JACKSONVILLE, FL. 32202 ATTN: ANGELA HERRON Requesting Permission to Construct: TELEPHONE CABLE (S I Is 9 Kr OC,e� p2 k\j Ci Location: (Reference to Cross-Street) Between 1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches. A Letter of Notification was mailed to the following Utilities/Municipalities: Jacksonville Electric Authority Yes(X) No ( Date: +-1_Oc� Bell South Telephone Company Yes( ) No ( Date: Ferrell Gas Yes(X) No ( Date: 9--7- Comcast Yes(X) No ( Date: cj--J-(�,S 2. 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 Director of Public Works, any or all of 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 Director of Public Works, and at the expense of the Permittee unless reimbursement is authorized. 3. All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the supervision of CLINT STRICKLAND (Contractor's Project Superintendent) located at Telephone#: 904-393-4958. 4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee. 5. 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. 6. 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 7. This permittee shall commence actual construction in good faith with 60 days. If the beginning date is more than 60 days from date of permit approval, then permittee must review the permit with the Director of Public Works to make sure no changes have occurred in the area that would affect the permitted construction. 8. 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. 9. The Director of Public Works shall be notified twenty-four (24) hours prior to starting work and again immediately upon completion. OWNER U,,X� Date:&2"S Signed: Before rr this --)rd daY­0A_T&1&_a(k)S in the County of Duval State Of Florida,has personally appeared U)"QWQ ?Z� 1� Notary Public at Large,State of F1 ida,County of Duval. My commission expires 0-\U_ — — — — — — — — — Personally Known: or JILL CRUZ Produced Identification: -AJIPL R� Notary Pd*-State of Floft 1W Cwaission Exores Mar 22,2W9 commission#DD 410139 B=W By NaWW=Assn. @ BELLSOUTH 11AA1,301 W. Bay St.,Jacksonville,FL 32202 Fax (904) 634-1773 Date: 9/7/05 RE: 890 Club Dr. (53E68154N) To Utilities in Proposed Work Area: This is to advise that BellSouth Telecommunications will be performing work as indicated on the attached job order. Please advise if you have any objections to the work as proposed. For additional information you may contact Angela Herron at 904-634-1661. JEA-Permits Distribution Eng., 4 th Floor 21 W. Church Street Jacksonville, Fl. 32202 Ferrell Gas 922 9TH St. South Jax Beach, FL. 32250 Comcast Cable 5934 Richard St. Jacksonville, Fl. 32216-5967 Attachment(s) 3 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 '41 INSPECTION EMAIL REQUEST: Bqi1ding-dept@coab.qs Application Number . . . . . 08-00000139 Date 2/06/08 Property Address . . . . . . 890 CLUB DR Application type description RIGHT-OF-WAY PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc INSTALL TELEPHONE CABLE ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BELL SOUTH TELECOMMUNICATIONS ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . UTILITIES PERMIT Additional desc Permit Fee . . . . . 00 Plan Check Fee . 00 Issue Date . . . . 2/06/08 Valuation . . . . 0 Expiration Date . . 2/06/08 ---------------------------------------------------------------------------- Special Notes and Comments Avoid damage to underground water/sewer utilities . Verify vertical and horizontal location of utilities . Hand dig if necessary. If field coordination is needed, call 247-5834 . ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total . 00 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total . 00 . 00 . 00 . 00 PERmrr-is APPROVED ONLY IN ACCORDANCE WITH ALL criry OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ----------- ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 INSPECTION EMAIL REQUEST: Building-dept(a) .,coab.us Application Number . . . . . 07-00001447 Date 10/16/07 Property Address . . . . . . 890 CLUB DR Application type description ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc REWIRE FOR EMERGENCY CONNECTION POINT ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MILLER ELECTRIC COMPANY 2251 ROSSELLE ST JACKSONVILLE FL 32201 (904) 388-8000 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Permit Fee . . . . . 00 Plan Check Fee . 00 Issue Date . . . . 10/16/07 Valuation 0 Expiration Date . . 4/14/08 ---------------------------------------------------------------------------- Special Notes and Comments APPLIED CREDIT. PERMIT AMOUNT $70.00 CREDIT AMOUNT $240 - $70.00= $170.00 AMOUNT OF CREDIT REMAINING. ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total .00 . 00 . 00 . 00 Plan Check Total .00 .00 . 00 .00 Grand Total . 00 .00 . 00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH ELECTRICAL PERMIT APPLICATION Date: Property Address: Owner: A/ �1_5�4&A�V- _ Telephone#: Contractor: Telephone#: Contractor Address: 2_Z_5/' L Fax #: 7 333 61 Contractor Signature: In consideration of permit given-46r—doing the "as described in the above statement, we hereby agree to perform said work in ons accordance with the attached plans and sp— Patio Athinh gre a part hereof and in accordance with the City of Atlantic Beach ordinance and standards of good practice listed therein. Building: Building Type: U Trailer Service: If other construction is Cl New C3 Residence U Temp. U New being done on this building Or site,list the building ,;a Old X Commercial U Signs increase Permit number: 0 Re-wire El Addition Sq.Ft. U Repair Conductor Size: AMPS: /,CX3 C PPER ALUMINUM n Switch or 12q� RACE Breaker AMPS PH W 3 VOLT W A Y Existing Service lzm6z RACE size AMPS PH W VOLT WAY Z"o Meter Number Feeders: NO. SIZE NO SIZE NO SIZE Lighting Outlets CONCEALED OPEN Receptacles ) CONCEALED OPEN Switches A 10 A WS 11 1AA AKA Incandescent Fluorescent & M.V. Fixed 0.100 AWS OVER BELL Appliances TRANSFER. Air H.P.RATING H.P. RATING CEILING KW-HEAT Conditioning COMP.MOTOR OTHER MOTORS AMPS HEAT Motors 0-1 H.P. VOLTAGE PH NO. OVER I H.P. PHS UNDER600V OVER600V Transformers NO. KVA NO. KVA No.Neon-Transf Ea. Sign I I I I Miscellaneous 4�_AV4jrza= -e_—&-Jr 7�: P-�n zde_ Ae-A&C-T2�&/ 800 Seminole Road 9 Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800-, Fax: (904)247-5845 9 httl2://www.ei.stlantic-beach.fl.us 2-C Revised 1/04 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 INSPECTION EMAIL REQUEST: Bui1ding-dept(a-,)qoqb.us Application Number 08-00000139 Date 3/06/08 Property Address . . . . . . 890 CLUB DR Application type description RIGHT-OF-WAY PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ------- ----- -- -- - -- - --- -- ---------- ---- - - - - --- ---- ---- - --- - - -- - ---- - -- ------ Application desc INSTALL TELEPHONE CABLE ------- -- ----- -- - ----- -- ------------------ ---- -- - - -- - - - - - ----- --- ---- -- I Owner Contractor ----------- -- --- -- ------ - --- ---- ---- ---- - ---- -- - BELL SOUTH TELECOMMUNICATIONS ATLANTIC BEACH FL 32233 ---------- ---- ---- --- --- ------------------------ --- --------- -- -- - - - - -- ------ Permit UTILITIES PERMIT Additional desc . . Permit Fee . . . . . 00 Plan Check Fee . 00 Issue Date . . . . 2/06/08 Valuation . . . . Expiration Date . . 2/06/08 ---- ------ ------ ------------------------------ ---- - ----- -- - --- ---- -- -- -- - --- Special Notes and Comments Avoid damage to underground water/sewer utilities . Verify vertical and horizontal location of utilities . Hand dig if necessary. If field coordination is needed, call 247-5834 . --- ------------ ------------ -- - ----- - -- - -- -- - -- - - -- ----- - --- - - -- - - - - - ------ -- Fee summary Charged Paid Credited Due --------- -------- -- -------- ---- -- - - -- - - -- - - - -- - - ------ --- Permit Fee Total . 00 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total . 00 . 00 . 00 . 00 i PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PERMIT crry OF ATLANTIC BEACH APPLICATION# BUH.MING/ZONING DEPARTAIENIP Boo Serninole,Road Atlantic Bead14 Florida 32233 (904)247-5900 (904)247-5845 Fax www.coab.us APPLICATION TRACKING FORM REQUtM DEPT: Y ttI;A PLANNING Property Address: (�WO CIUb W/ vo z BUILDING N PUBLICWQRKS Applicant: 7- e Al n u n 'Cat FIRE Project: Cab Y� m Pusuc SAFETY J U) -APPROVAL Lu REQUIRED AGENCY: RECEIVED BY� INITIAL, DATE. 0 z 1w, W 0� Y N D.E.P HUFSTETLER 05 <(3 Y N S.J.PW.K CARPER W It Y N ARMY CORPS of ENG CARPER iE HU[FSTEnF_R, 0_ Y N HOTELS&RESAURANTS APPLICATION STATUS CIRCLE ONE SITE BUILDING DA AP REVIEVVEDAY: &tJ1kL DATE: I ST GA 4) PLANNING BUILDING 0 2ND REV F-1 0 PU 0 WO P41CY ES FIRE DEPT. PUBLIC SAFErY .o i V101 0 1 �V__ A OAftft NJ CITY OF ATLANTIC BEACH CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS 800 Sernmole Road 247-5WO Atlantic Beach.Florida 32233-5445 Fax 904-247-5845 Date 1 -17 -09 PERMIT# Job Address C I Uk T)r- o ISSUED BY THE CITY Permitee: BELLSOUTH TELECOMMUNICATIONS Telephone# 904-777-9052 14 Permittee Address: 7666 BLANDING BLVD JACKSONVILLE, FL. 32244 ATTN: NICOLE PADRON Requesting Permission to Construct: TELEPHONE CABLE Location: (Reference to Cross-Street Club, br -i Bewh- Ave. 1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches. A Letter of Notification was mailed to the following Utilities/Municipalities: Jacksonville Electric Authority Yes(X) No Date: /-/7-09 Bell South Telephone Company Yes( ) No Date: Ferrell Gas Yes(X) No Date: /-/7-09 Comcast Yes(X) No Date: 1-/7-08 2. 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 Director of Public Works, any or all of 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 Director of Public Works, and at the expense of the Permiftee unless reimbursement is authorized. 3. All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the supervision of CLINT STRICKLAND Contractor's Project Superintendent) located at Telephone#: 904-393-4958. 4. All materials and equipment shall be subject to in;��tion by the Director of Public Works or his designee. 5. 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. 6. 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 7. This permittee shall commence actual construction in good faith with 60 days. If the beginning date is more than 60 days from date of permit approval, then permittee must review the permitwith the Director of Public Works to make sure no changes have occurred in the area that would affect the permitted construction. 8. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the Cit)(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. 9. The Director of Public Works shall be notified twenty-four (24) hours prior to starting work and again immediately upon completion. OWNER Dee: Before=this ay of J;"-&N 0 the County of Duval, State Of Florida,has personally appeared_Wvaoie tWron en Nc!zry Publlz-Stece of Florkia Notary Public at Large,State of F19grida,County of al. jsmiz L 1-111hijay My cornnftion Worm I-Ay DD434332' Personally Known: or Exph-.05.(26rAW Produced IdentWication: CITY OF ATLA NTIC BEACH PERMIT BUILDING /ZONING DEPARTMENT APPLICATION # �'J '000 Seminole Road Atlantic Beach,Florida 32233 (904)247-5000 561 (904)247-5845 Fax vrvvw.coab.us APPLICATION TRACKING FOF REQUIJRM DEPT: y �N'A PLANNING Property Address, (�WO CIUb L�ri V-(-) z BUILDING P: =) a N Applicant: PUBLICUTILITIES y FIRE DEPT. Project: Y(-N,/ PUBLIC SAFET Y C/) Lu -APPROVAL 0 0 REQUIRED AGENCY: RECEIVED BY: INITIAL: DATE: z uJ W n' Y IN D.E.P HUFSTETLER 0 5 0 Y N S.J.R.W.M. CARPER UJ uJ c� Y N ARMY CORPS of ENG CARPER 0 Y N I HOTELS&RESAURANTS HUFSTETLER APPLICATION STATUS CIRCLE ON E: SF;E, BUILDING DA AP REVIEWED BY: INITIAL: D4TE: I ST REV 0111-> PLANNING BUILDING 1 2NDREV1111 El I OUB �S PUBLIC UTILITIES FIRE DEPT. PUBLIC SAFETY 3RD REV nmee vnu have entered voiur Comments into the AS400. V.- CITY OF ATLANTIC BEACH CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS -247-5800 800 Seminole Road 904 Atlantic Beach,Florida 32233-5445 Fax 904-247-5845 Date 17 68" PERMIT# ISSUED BY THE CITY Job Address Cluk J)r. D111 0 1 - I Permitee: BELLSOUTH TELECOMMUNICATIONS Telephone# 904-777-9052 1( 390 Permittee Address: 7666 BLANDING BLVD JACKSONVILLE, FL. 32244 ATTN: NICOLE PADRON Requesting Permission to Construct: TELEPHONE CABLE Location: (Reference to Cross-Street) Clu6 J 'Beclah hue,. br -1 1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches. A Letter of Notification was mailed to the following Utilities/Municipalities: Jacksonville Electric Authority Yes (X) No ( ) Date: Bell South Telephone Company Yes( ) No ( ) Date: Ferrell Gas Yes(X) No Date: /-/7- 09 Comcast Yes (X) No Date, /-/7- 09 2. 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 Director of Public Works, any or all of 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 Director of Public Works, and at the expense of the Permittee unless reimbursement is authorized. 3. All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the supervision of CLINT STRICKLAND _(Contractors Project Superintendent) located at Telephone#: 904-393-4958. 4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee. 5. 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. 6. 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 7. This permittee shall commence actual construction in good faith with 60 days. If the beginning date is more than 60 days from date of permit approval, then permittee must review the permit with the Director of Public Works to make sure no changes have occurred in the area that would affect the permitted construction. 8. 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. 9. The Director of Public Works shall be notified twenty-four (24) hours prior to starting work and again immediately upon completion- OWNER Signed:flkt� Date: 1 -0-09 Before me this 1-7w' ay of- I e County of Duval, 0 2612009 _Oie, State Of Florida,has personally appeared NJ%00ie, ron V.V P4, M!clt-,ry PuV�Strlte of Florida Notary Public at Large,State of FI i9a,County of Duval. V11niley My commission expires: 0804 DD434332 Personall Known: or Expircn 15, y Produced Identification: CITY OF ATLANTIC BEACH PERMIT BUILDING / ZONING DEPARTATENT APPLICATION # '000 Seminole Road Atlantic Beach,Florida 32233 -00 4� (904)247-�a (904)247-5845 Fax www.coab.us ?00,6 APPLICATION TRACKING FORM 16 REQUIPA-D, DEPT: Y PLANNING 0 Property Address., u BUILDING (I?rl) N PUBLIC WORKS AppReant: 6rit LY/ 14'7� PUBLIC UTILITIES Comm iin i C a�b X5--0 Project: I h _ Y(.,J� FIRE D-EPT. Y(_N,---' PUBLICSAFETY U) -APPROVAL REQUIRED AGENCY: RECEIVED BY: INITIAL: DATE Z La' LU fy, Y N D.E.P HUFSTETLER C.D 5 <a Y N S.J.R.W.M. CAPPER re Lu Ul= Y N ARMY CORPS of ENG CAPPER 0 Y N HOTELS&RESAURANTS HUFSTETLER APPLICATION STATUS CIRCLE ONE: SITE- BUILDING DA AP REV14VED.Bl(: -AITIAL: DATE: I ST REV PLANNING BUILDING 2NDREV 0 0 PU WO S PUB IC IES F1 PDEPT. PUBLIC SAFETY I 3RDREV101 1:1 1 1 1 e,%- A QAnn CITY OF ATLANTIC BEACH CONSTRUCTION PERMIT WITHIN CITY.RIGHTS OF WAY AND EASEMENTS 800 Seminole Road 904-247-5800 Atlantic Beach,Florida 32233-5445 Fax 904-247-5845 Date— 1/23/2008 Job Address 890 CLUB DR. Permitee: BELLSOUTH TELECOMMUNICATIONS Telephone# 904-350-2273 Permittee Address: 1 1AA1, 301 W. BAY ST., JACKSONVILLE, FL. 32202 ATTN: KENNY ANDERSON Requesting Permission to Construct: TELEPHONE CABLE, SPLICE PITS Location: (Reference to Cross-Street) SEE DRAWINGS 1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches. A Letter of Notification was mailed to the following Utilities/Municipalities: Jacksonville Electric Authority Yes (X) No Date: IL2LIV:? Bell South Telephone Company Yes ( ) No Date: Ferrell Gas Yes (X) No Date: iIM709 Comcast Yes (X) No Date: i I;?-rkog 2. 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 Director of Public Works, any or all of 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 Director of Public Works, and at the expense of the Permittee unless reimbursement is authorized. 3. All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the supervision of BRIAN MEGOWAN _(Contractor's Project Superintendent) located at Telephone#: 904-704-3309. 4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee. 5. 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. 6. 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 7. This permittee shall commence actual construction in good faith with 7 days. If the beginning date is more than 60 days from date of permit approval, then permittee must review the permit with the Director of Public Works to make sure no changes have occurred in the area that would affect the permitted construction. 8. 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. 9. The Director of Public Works shall be notified twenty-four (24) hours prior to starting work and again immediately upon completion. OWNER OY Notar-,Pubiic State of Florida Signed: Date: Susan A Allen Beforemethis Z-3 dayof T1Z;11 the County of Duval, My Commission D0380304 State Of Florida, has personally appeared 1,0F 0 Expires 12/19/2008 Notary Public at Large,State of Florida,County of Duval. My commission expires: 1!1 200P Personally Known: or 0%4t� Produced Identification: IF S!EA OA .......... f I OCEAN 'OAf, nor 3:1 .......... C pt BEACH I-r I MEAN hA -------------------- HAN, MOM Woo" ............,, MIR' Imp M ................ .......... .......... s Ay 777777777 3 . . . .. . . . . .. -72-0- 1� P� !AA 01 �O�Vl CITY OF ATLANTIC BEACH 800 SEW"OLE ROAD A�MA�MC 131EACH,JFL 32233 INSPECTION P14ON-E LM 247-5826 INSPECTION EMAIL REQUEST: Building-depL@.c-0ab..US Application Number . . . . . 08-00000111 Date 1/28/08 Property Address . . . . . . 890 CLUB DR Application type description RIGHT-OF-WAY PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc TELEPHONE CABLE INSTALL ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BELL SOUTH TELECOMMUNICATIONS ATLANTIC BEACH FL 32233 ----------------------------------------- ---------------------------------- Permit . . . . . . DRIVEWAY PERMIT Additional desc . . Permit Fee . . . . . 00 Plan Check Fee . 00 Issue Date . . . . 1/28/08 Valuation . . . . 0 Exp iration Date . . 7/26/08 ----------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total . 00 . 00 . 00 . 00 Plan Check Total . 00 .00 . 00 . 00 Grand Total . 00 . 00 . 00 . 00 PERMIT IS "PROVED ONLY IN ACCORDANCE WITII ALL CITY OF ATLANTIC REACH ORDINANCES AND THE FLORIDA BUILDING CODES. 71 CITY OF ATLANTIC BEACH PERMIT BUMI)ING /ZONING DEPARTAIENT APPLICATION 800 Seminole Road Atlantic Bimch,Florida 32233 A, -5-00 (904)247 0 (904)247-5845 Fax vrww.coab.us APPLICATION TRACKING FOR REQUIFAI�' DEPT: z BUILDING Y PLANNING Property Addres 9.* u ( e)N PUBLIC WORKS AppUcant: 6r i t C_5�by-th ('6rn1nvniCa�hb)1;4__ _)V N Y ,0/') FIRE DEPT. Project: &P If, ycw,/ PUBLIC SAFETY f C/) -APPROVAL REQUIRED AGENCY: RECEIVED BY: INITIAL: DATE: Z Lu, LU y N D.E.P HUFSTETLER <a Y N S.J.R.W.M. CARPER M W - LU 0� Y IN ARMY CORPS of ENG CARPER 0 Y N HOTELS&RESAURANTS HUFSTE-:TLER APPLICATION STATUS CIRCLE ONE: SITF_/ BUILDING DA AP, REVIEWED BY: INITIAL: PATE: I ST REV PLANNING BUILDING C1 11 2ND REV I0 I El I R PUBLIC UTILITIES FIRE DEPT. PUBLIC SAFETY 13 1 13RDREVI [] I I I I Pafmrm fhiQ fhrrn fn ths. once vnRA have entered vour comments into the AS400. CITY OF ATLANTIC BEACH CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS 800 Seminole Road 904-247-5800 Atlantic Beach,Florida 32233-5445 Fax 904-247-5845 Date— 1/23/2008 F PERMIT# Job Address 890 CLUB DR. I ISSUED BY THE CITY Permitee: BELLSOUTH TELECOMMUNICATIONS Telephone# 904-350-2273 Permittee Address: 1 1AA1, 301 W. BAY ST., JACKSONVILLE, FL. 32202 ATTN: KENNY ANDERSON Requesting Permission to Construct: TELEPHONE CABLE, SPLICE PITS Location: (Reference to Cross-Street) SEE DRAWINGS 1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches. A Letter of Notification was mailed to the following Utilities/Municipalities: Jacksonville Electric Authority Yes (X) No Date: 1LZL1,9:F Bell South Telephone Company Yes ( ) No Date: Ferrell Gas Yes (X) No Date: 17231og Comcast Yes (X) No Date: i 9-5 2. 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 Director of Public Works, any or all of 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 Director of Public Works, and at the expense of the Permittee unless reimbursement is authorized. 3. All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the supervision of BRIAN MEGOWAN _(Contractor's Project Superintendent) located at —Telephone#: 904-704-3309. 4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee. 5. 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. 6. 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 7. This permittee shall commence actual construction in good faith with 7 days. If the beginning date is more than 60 days from date of permit approval, then permittee must review the permit with the Director of Public Works to make sure no changes have occurred in the area that would affect the permitted construction. 8. 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. 9. The Director of Public Works shall be notified twenty-four (24) hours prior to starting work and again immediately upon completion. OWNER W P&, Notai, Ouolic Sta Signed: Date: 4P Susan A Allen te of Florida Before me this day of Ia,-i -I!q the County of Duvall My Commission D0380304 ^1m:)6eso A/ State Of Florida, has personally appeared eC-N"AA -OF Expires 12/19/2008 Notary Public at Large State of Florida County of Duval. My commission expire�: I 1,20op Personally Known: or Produced Identificatiom .512-9w 6prl ep t'-O�AVJ- �'� C4 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ................... ---------- " —..........11— ........................ ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 INSPECTION EMAIL REQUEST: Building-deptna ,coab.us Application Number . . . . . 08-00000111 Date 1/29/08 Property Address . . . . . . 890 CLUB DR Application type description RIGHT-OF-WAY PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc TELEPHONE CABLE INSTALL ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BELL SOUTH TELECOMMUNICATIONS ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . UTILITIES PERMIT Additional desc . . Permit Fee . . . . . 00 Plan Check Fee . 00 Issue Date . . . . 1/29/08 Valuation . . . . 0 Expiration Date . . 1/29/08 ---------------------------------------------------------------------------- Special Notes and Comments Avoid damage to underground water/sewer utilities . Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is needed, call 247-5834 . ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total . 00 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total . 00 . 00 . 00 .00 PERMIT IS "PROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES.