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2301 Mayport Rd Sprint 2014 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 SA Application Number . . . . . 14-00000512 Date 4/11/14 Property Address . . . . . . 2301 MAYPORT RD Application type description RIGHT-OF-WAY PERMIT Property Zoning . . . . . . . COM GENERAL DISTRICT Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc ANTENNAS, RADIOS, CABLE & CABINET TO EXIST SITE ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CITY OF ATLANTIC BEACH OWNER 800 SEMINOLE RD ATLANTIC BEACH FL 322335428 ---------------------------------------------------------------------------- Permit . . . . . . RIGHT OF WAY PERMIT Additional desc . . Permit Fee . . . . . 00 Plan Check Fee . 00 Issue Date . . . . 4/11/14 Valuation . . . . 0 Expiration Date . . 10/08/14 ---------------------------------------------------------------------------- Special Notes and Comments Contact Mark Lyon, Public Works Inspector at 838-8076 before starting work. ---------------------------------------------------------------------------- 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. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 APR NIS 2%4 Job Address: 2301 Mgyport Rd. Atlantic Beach, FL 32233 q- By Legal Description Parcel# 169398 0070 Floor Area of Sq.Ft. Sq Ft Valuation of Work S 30,000.00 Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition <� Repair Move Demolition pool/spa window/door Use of exi�ting/pro osed structure(�) (circle one): Residential If an existing structure,is a fire sprinkler system instal lecITTUTFE-W one): Yes No N/A Florida Product Approval# For multiple products use product approval lorm Describe in detail the type of work to be performed: Adding antennas, radios, cable & cabinet to existing telecommunications site. Property Owner Information Name: Cijy of Atlantic Beach Address: 800 Seminole Rd. City Atlantic Beach —State FL Zip 32233 Phone 904-247-5826 E-Mail or Fax#(Optional)904-247-5845 Contractor Information: Company Name: Betacom, Inc. Qualifying Agent: Ronald Mooney Address: 9331 E. Fowler Ave. City Thonotosassa State FL Zip 33592 Office Phone 813-986-4922 Job Site/Contact Number 352-205-0253 Fax 813-982-0882 State Certification/Registration# CGC1515461 Architect Name&Phone#Robert Lara 954-577-4655 Engineer's Name&Phone#Yan Wang 954-577-4655 Fee Simple Title Holder Name and Address Sprint-63 91 Sprint Parkwqy, Overland Park, KS 66251 Bonding Company Name and Address N/A Mortgage Lender Name and Address N/A I a, e ade bana ermit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the 11 be performed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null A"9P ic c io 's r by md th to 0 t 'rk p i8suan e o a e a" at al w i mit 1 0 w ,ndv'id f Pk s not com en ed w thin six((6)months, or if construction or work is suspended or abandonedfor a period of six�6)months at any time after is co Or,i m c i c . I u 's , t t s W, k e ed nde ta d ha eparate permits must be securedfor Electrical Work, Plumbing,Signs, ells, PMs, Purnaces, Boilers,Heaters, Tanks and Air Conifitioners,etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Ihere certify that I have read and examined thisa lica ion and know the same to be true and correct. All provisions of laws and ordinances governing this c e§ ereinornot. The granting of a permit does not presume to give authority to violate or cancel the 1�work will be co�nplied with whether sfe Xi provisions ofany otherfederal,state, or local aw regul ting construction or the pe�jbrmance of construction. Signature of Ownerjs�, Signature of Contractor Print Name Print Nam W)cd ......................................... ..........................I e �R - d ..................... Swoqi to d subscribe before me Sworn to and subscribed before me thi it ay t 20 this 31 Day of IAA&Qb A0,114 20 s AAA CU" Not4ry Public 'V.�O�Corefmissjon#LE-'020599 BETH ANN BISHOP ,,%F Expires November 28,2014 MY COMMISSION#FF 01M Bonded Thru Troy Fain Insu,a.NO 3851011 Revised 01.26.10 EXPIRES:May 20,2017 111075e Bor4edThru Budpt Notary Strvices Sprint March 7, 2014 RE: Letter of Authorization for licenses, permits or approvals by RG Partners, Inc as authorized agent for Sprint To Whom it may Concern: Sprint herby authorizes RG Partner.s, Inc to act on it's behalf in connection with wireless facilit� upgrades in the South Florida market. This includes secunng necessary licenses, lease amendments, signing permit applications, as well as all other necessary permits or approvals required in connection with telecommunications facility modifications Authorized individuals include.- Andrew BlIznakoff Very truly yours, Sprint By: Naml;: Jason Laskey L Title: Real Estate Manager Program Manager III Phone: 305-321-5655 STATE OF FLORIDA COUNTY OF 1:5 r-6vo r>-, The foregoing instrument was acknowle 1w1ore me this MctfC�� LDI.�[_ (date), by Jason Laskey, Sprint Real Estate Manager, who isoersonaLll �n� o�wp n�tom or who ha�produced (type oTidentif—ication) as identification. Notary Public VIZZ-A-4K, MICHAEL LI;ET Printed Name: Mi IDLe Notary Public-State of Florida Z My Comm.Expires Noy 16.2014 7A,:' Commission#EE 42724 2-014 My Commission Expires: ,,0....�` Bonded Through National Notary Assn.. Commission # F_GA�1�11 I - - -own" 6700 N. Andrews Ave, Suite 700, Fort Lauderdale, FL 33309 City of Atlantic Beach APPLICATION NUMBER Building Department MBER g DDepartment.) (To be assigned by the Building Department.) 800 Seminole Road �P'g Atlantic Beach, Florida 32233-5445 f Vo L[ '5 Phone(904)247-5826 - Fax(904)247-584 E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: -230 1Q0A Department review required Yes No Building Applicant: _R)CtaC4y_n Planning &Zoning Tree Administrator Project: - Ao-�c nncAs rad ublic W r Public Utilities Public Safety Fire Services Review fee b e p-t S* ig-n-at u-ne- Other Agency Review or Permit Required Review or Receipt of Permit Verified By Date Florida Dept. of Environmental Protection Florida Dept. of Transportation St.Johns River Wat�r Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other., APPLICATION STATUS Reviewin Department FFirst Review: 9 Irst R Approved. DIDenied. Ell (Circle one.) Comments: e_ BUILDING PLANNING &ZONING Reviewed by: ..Date: TREE ADMIN. Second Review: DApproved as revised= [E]D$ee d. CEE�) Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES rThird Review: E01ApProved as revised.7E]Denied. Comments: Reviewed by: Date: Msed 05114/09