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
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Application desc
ANTENNAS, RADIOS, CABLE & CABINET TO EXIST SITE
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Owner Contractor
------------------------ ------------------------
CITY OF ATLANTIC BEACH OWNER
800 SEMINOLE RD
ATLANTIC BEACH FL 322335428
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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
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Special Notes and Comments
Contact Mark Lyon, Public Works Inspector at 838-8076
before starting work.
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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 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