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'
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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
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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
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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.