469 11TH ST VERIZON CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J
- ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
s.�Jiil�r
RIGHT OF WAY PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 _
JOB INFORMATION:
Job ID: 15-ROW-1497
Job Type: RIGHT-OF-WAY PERMIT
Description: coax cables and cabinets for verizon
Estimated Value:
Issue Date: 7/7/2015
Expiration Date: 1/3/2016
PROPERTY ADDRESS:
Address: 469 11TH ST
RE Number: 172026-0000 _
PROPERTY OWNER:
Name: CITY OF ATLANTIC BEACH
Address: 800 SEMINOLE RD
PERMIT INFORMATION:
CONTRACTOR: BETA COM
FEES:
Total Payments: $0.00
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
Job
gAddress: 469 11`s St Atlantic Beach FL 32233
2s-Od Floor Area of Sq.Ft. Sq.Ft
Valuation of Work S Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one): Commercial Residential
If an existing structure,is a fire sprinkler system nista one): Yes No N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: Install(1)wireless antenna,(4)coax cables and swap out existing_
Equipment cabinet with new cabinet.
Property Owner Information: 77 00 �a
Name: Verizon Wireless(lessee) �° 'City Boca Raton State FL Zip 3348714f:
ne 7 949 ��_ 11or- rl lV-7
E-Mail or Fax#(Optionallaura.roberts@verizonwireless.com 1 /O
Contractor Information: �` W a'1`r4 &,31.ia r /
Company Name:Betacom,Inc Qualifying Agent:Ronald C Mooney
Address:9331 E Fowler Ave City Thonotosassa-State FL Zip 33592
Office Phone 813-9864922 Job Site/Contact Number Fax#813-982-0882
State Certification/Registration# CGC1515461
Architect Name&Phone# ti
Engineer's Name&Phone#Kimley Hom,561- -0243
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address 4t i
Application is herebv made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of a!!laws regulating construction in thisjurisdiction. This perat mit becomes null
work is commenced.o menced.not
I understand within ix that separate permits must bmonths,or if e construction
for Electrical-Work,Plumbing,Signs,aWells,Pperiod ols,Furnacemons,sBoilers,t Heaters,
Tanks and Air Conditions,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 BEFR ENTE RECORDING YOUR NOTICE OF
I hereby certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
provisions ofan�y o ere lied with ralstate,,whether!re r g lacing construction oherein or not. The r pew rfinance of constructiermit does not onresume to give authority to violate or cancel the
Signature of Owne Signature of Contractor
� ... Print NameQn. .l ...... ....... . + .. .....................................
PrintName _�.�-................................................................................
Sw and subsc d before me Sworn d subscribed before me 20 15
thi&Day of 2015 this ay of ss rr�t
k. cry
Notary Public Notary Pu lie
Revised 01.26.10
FILE COPY
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 24-7}-5826 Fax (904) 247-5845
-l)
JOB ADDRESS: �6 /'� 1 - ` _PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$ d
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
Residential(Main) Service am #of Meters
0-100 amps 101-150amps 151-200amps - Ps
-Commercial(Main) Service
-0-100 amps I101-150amps C 151-200amps amps - CT Service amps
Conductor Type Size
Multi-Family(Main)Service
0-100 amps --101-150amps F 151-200amps amps #of Unit Meters
Temporary Pole ' amps
SERVICE UPGRADE i- amps CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) CT Service amps
,100 amps -'150amps 200amps amps p
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
Swimming Pool - Sign jSmoke Detectors_Qty ❑Transformers KVA Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK$
Qty volts/amps
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can Safety Inspection Panel Change OH to UG
Other:
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have
read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether
specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction.
Property Owners Name Verizon Wireless (lessee)
Phone Number 561-226-9493—
Electrical Company Betacom, Inc Office Phone 813-986-4922 Fax813-982-0882
Co.Address: 9331 E Fowler Ave City Thonotosassa_State FL Zip 33592
License Holder (Print): Ronald C Mooney State Certification/Registration#CGC1515461jkA-10ZZZ2
Notarized Signature of License Holder
DIANE K.BRACE Sworn and subscribed before me this day of Ci 20
MY COMMISSION#FF060744 �
° EXPIRES:OCT 07,2017 Signature
� of Notary Public
Bonded through 1st State Insurance