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469 11TH ST - RIGHT OF WAY 7 s, CITY OF ATLANTIC BEACH ;� s) 800 SEMINOLE ROAD J ;". ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 �N � :1•JI319� 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: $0.00 PERMIT IS APPROVED ONLY IN ACCORDANCE wurit ALL CITY OF ATLANTIC BEACH ORDINANCES AND 771E FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach,FL 32233 Office(904)247-5826 Fax(904)247-5845 Job Address: 469 11th St,Atlantic Beach,FL 32233 Legal Description 17-2S-29E 1.791,Pt Govt Lot 5 Rcd DBK 1761-104,O/R 6444-1268 Parcel# 172026- z/ �-0� Floor Area of Sq.Ft. Sq.Ft Valuation of Work$ 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): Commercia Residential If an existing structure,is a fire sprinkler system costa •I. - • one): Yes No 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 F Equipment cabinet with new cabinet. Property Owner Information: . 14 . (T '. '/. ,t'2 /, Name: Verizon Wireless(lessee) 777 � 00 4 a/� City Boca Raton State FL Zip 33487 P one P!. 949 / ^ // E-Mail or Fax#(Optionallaura.roberts@verizonwireless.com -7�G - VAT-- " /D 6 Contractor Information: /—cf''1n/Gt 4.1- Ali awlea; 1,c't7.v1 Company Name:Betacom,Inc Qualifying Agent:Ronald C Mooney Address:9331 E Fowler Ave City Thonotosassa State FL Zip 33592 Office Phone 813-986-4922 Job Site/Contact Number Fax#813-982-0882 State Certification/Registration# CGC1515461 Architect Name&Phone# 4,4 Engineer's Name&Phone#Kimley Horn,561- /-0243 , /f,c Fee Simple Title Holder Name and Address t /, a!' /.' i Jam''A /, G &.GCG 4 Bonding Company Name and Address,k Mortgage Lender Name and Address A/ Application is hereby made to obtain a permit to do the work and installations as indicated. /certify that no work or installation has commenced prior to the issuance ofa permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6)months,or if construction or work is suspended or abandoned for a period of six(6)months at any time after work is commenced. I understand that separate permits must be secured for ElectricalpWork,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters, Tanks and Air Conditioners,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. /hereby certify'that/have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will :. .lied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any o .-ral,state,or local law regulating construction or the performance of construction. Signature of Owne A Signature of Contractor ./ Print Name aC)- �f�� _..__ . ... ._. ... ........ Print Name bn2J.d Dui eci Swo and subsc . before me C Sworn,m*1d subscri before me thiDay of 2 15 this ate'Oay of .20 15 Notary Public Notary Public Revised 01.26.10 1 FILE COPY ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach, FL 32233 Ph (904) 247-5826 Fax (904) 247-5845 JOB ADDRESS: `/b g f/y A, j - ± PERMIT# JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE VALUE OF WORK$ Sl 00 6, NEW SERVICE ❑ Overhead n Underground ❑J Underground up Pole Residential(Main)Service 10-100 amps 101-150amps 1 151-200amps amps #of Meters Commercial(Main) Service 10-100 amps 101-150amps [ 151-200amps amps CT Service amps Conductor Type Size Multi-Family(Main) Service 0-100 amps 101-150amps 151-200amps amps #of Unit Meters Temporary Pole amps SERVICE UPGRADE amps CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) 100 amps 1150amps 1200amps amps CT Service amps 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 : Smoke Detectors Qty Transformers KVA Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans) Qty volts/amps VALUE OF WORK$ 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#CGC 15154617_.2Z2_- Notarized Signature of License Holder A-1 0 C�., DIANE K.BRACE i Sworn and subscribed before me this day of (�'�1(Xi 20°`� MY COMMISSION#FF060744 ') Q `J j EXPIRES:OCT 07,2017 Signature of Notary Public . GliV , I'S .e))-1XP'1 Bonded through 1st State Insurance •---Rkr. City of Atlantic Beach --±�, ' :11 Building DeparbnentT APPLICATION NUMBER ,, 800 Seminole Road (To be assign by JUN l ex Building Department.) Atlantic Beach, Florida 32233 5445 4115 I // n (�� Phone(904)247-5826 • Fax(904)241'45 7 "':./..',,,-56i :-./i E-mail: building-dept @coab.us City web-site http://www.coab.us _�� Date routed: i 3 APPLICATION REVIEW AND TRACKING FORM Property Address: / 9 ///7( S / -- Department review required 111= No Applicant: — Building — 1_ �i/� Planning &Zoning - - "( Tree Administrator Project: __. 0 frt_/_,...,5______________. ,L71.--lic Wor. Fire Services --� ___. Review fee $ Dept Signature Other Agency Review or Permit Required Re WIV a or Re eC 1"pt '— of Permit Verified By Date Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District MI Army Corps of Engineers Division of Hotels and Restaurants IMMIIIIIIIIIIIIIIIIIIIIIIII Division of Alcoholic Beverages and Tobacco MEMOther: APPLAT[ON STATUS Reviewing Department First Review: [ Approved. - --- --- ------- --------- ---------� (Circle one.) Comments: ❑Denied. BUILDING PLANNING &ZONING ��C' Reviewed by: i TREE ADNIIN. —_ • Date: LG / Second Review: nApproved as revised. _ 7 enied. PUBLIC WORKS Comments: I PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: -- � Da _ te: FIRE SERVICES Third Review: nApproved as revised. �� - nDenied. Comments: _ -_- Reviewed by: Date: Revised 07/27/10 r 's ^i;`); City of Atlantic Beach -C: ,.�: \ Building Department / APPLICATION NUMBER("2 800 Seminole Road } SUN 2T i /(To be assigned by the Building Department.) i r' Atlantic Beach, Florida 32233 5445 D1jr % 1 �� Phone(904)247 5826 Fax(904)247 5845 /� �O� 7 9 '' .c-i;t ��o E-mail: building-dept @coab.us �' aZ City web-site: http://www.coab.us `\. Date routed: APPLICATION REVIEW AND TRACKING FORM Property Address: i 9 ///w Department review required len No Applicant: Building Planning &Zoning _IN _ Tree Administrator - Project: C0 Ie_5 MIN ! 1" _- Elm imamminsimmul Review fee $ Dept Signature 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 Water Management District Army Corps of Engineers .. .1=1041 Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco IIIIIMIIIIIIIImIMMIIII Other: APPLICATION STATUS Reviewing Department First Review: (Circle Approved. ❑Denied. ( le one.) Comments: BUILDING PLANNING &ZONING � _ Reviewed by: 4 f f. 11" TREE ADMIN. Date: Second Review: ['Approved as revised. '.4"�H!-IC WOyQKS •Comments: ❑Denied. PUBLIC ILITIES PUBLI S/4 TY Reviewed by: Date: FIRE SERVICES Third Review: �� ----_--- ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 07/27/10 Kimley>>>Horn May 28,2015 • Suite 200 1920 WekivaWay West Palm Beach,Florida Laura Roberts 33411 SBA Communications Corporation 8051 Congress Avenue Boca Raton, FL 33487-1307 Re: Proposed Verizon Wireless Antenna Installation Mayport Road Water Tower 469 11"'Street Atlantic Beach,FL 32233 To whom it may concern : In accordance with our agreement, Kimley-Horn and Associates, Inc., has performed an evaluation for the the addition of one(1)Verizon Wireless antenna X7CQAP-665-VRO-IPB and one(1)antenna mount and four(4)coax cables to the existing water tower referenced above. The proposed Verizon antenna, mount and coax cables will not add significant loads to the water tower,water tower handrail nor its foundation when compared to the original loads or the wind surface area of the water tower. It is therefore, based on the above reasoning,that the water tower can safely resist the proposed Verizon Wireless antennas. Please call me at(561)845-0665 if you have any questions. 1111 Very truly yours, .\\‘O r� �I/f KIMLEY-HORN AND ASSOCIATES,INC. , {+;'// CA 00000696 ••A: •,� Ii� No.70645 . * Al 4 wr::: 'ILMIV4441[ P, /1,4'�i r' ;'s';_°; �f. Arnold()A.Artiles, P.E. �!/ll/li l iilkON FL P.E. 70645 ■ TEL 561 845 0665 FAX 561 863 8175