196 Seminole Rd ROW permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
RIGHT OF WAY - SINGLE OR TWO FAMILY RIGHT OF WAY
MUST CALL BY 4PM FOR NEXr DAY INSPECrION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ROW17-0014
Description: JEA-35 FOOT POLE
Estimated Value: 0
Issue Date: 8/16/2017
Expiration Date: 11/14/2017
PROPERTY ADDRESS:
Address: 196 SEMINOLE RD
RENumber: 1706920000
PROPERTYOWNER:
Name:
Address:
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: JEA
Address:
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work,a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
City of Atlantic Beach APPLICATION NUMBER
Building Department fro be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 Rowi�LOC)L4
Phone(904)247-5826 Fax(904)247-5845
��t E mail: building-dept@coab.us Date routed;
Cityweb-site: hftp://�.wab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Department review required Yes No
Building
Applicant: Planning &Zoning
Tree Administrator
Project: LGJ_-( CI) Aq Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review
pt
of Pe By Date
Florida Dept. of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
:Reviewing Department First Review: ElApproved. ElDenied. ;4Not applicable
(Circle one.) Comments:
BUILDING
LANNING&ZONING Reviewed by: Datqr-:11
TREE ADMIN. Second Review: FlApproved as revised. F _]Not applicable
]Demed. F
(-PUGSLICWORK�S Comments:
(!�E�
PUBLIC SAFETY Reviewed by: Date*
FIRE SERVICES Third Review: [—]Approved as revised. [3Denied. E]Not applicable
Comments:
Reviewed by: Date
Revised 05/1912017
City of Atlantic Beach r)v�7ZC;EJAI APPLICATION NUMBER
Building Department I (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach,Florida 32233,5445 AVG I I 2W 4
Phone(904)247-5826- Fax(904)247- 'k
E-mail: building-dept@coalb.us Date routed-
City%veb-slte: hftp://�.coab,us
APPLICATION REVIEW AND TRACKING FORM
Property Address: :SEAAJK30 ( _E kQ De artment review required Yes No
Building
Applicant: Planning &Zoning
Tree ministrabor
Project: R.CaL-( C-) P- Public Works
ublic Utilities
_SS I POL�(= Public Safety
Fire Services
IFU
Review fee Dept Signature
Other Agency Review or Pernlit Required Review MorReCeipt
to
of Permit Verified By Date
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
10therW M
APPWATION STATUS
Reviewing Department First Review: [�]Alpprovecl. []Denied. "E'lNotapplicable
(Circle one.) Comments:
BUILDING
_$jNNING�&ZONING
Reviewed by: Date
't
TREEADMIN. Second Review: DApproved as revised. ElDen'ted. []Not applicable
'WO
RKS�:) Comments:
(�_fUBUC�UTILITIE�S
PUBLIC SAFETY Reviewed by: Date
FIRE SERVICES Third Review: ElApproved as revised. LIDenied. ONot applicable
Comments:
Reviewed by: Date:-
Revised 05/1912017
City of Atlantic Beach APPLICATION NUMBER
Building Department a y
800 Seminole Road (To be assigned iby the LBuiIdZgDepaEitmTenL])
Atlantic Beach, Florida 32233-5445 AUG 1 2017 4
a r
Phone(9G4)247-5826- Fa�(904) �-5845
E mail: building-dept@coeb.us BY
Date routed:
City web-site: hftp:/1ww%v.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: SEA&XK�ot-E kQ De artml review required Yes No
Building
Applicant: Planning &Zoning
I ree dministrator
Project: R.CaLl c) F- b ic Wor §
P icutilities
P b ic Safety
Fire Services
Review fee Dept Signature 5E/�
0 En
ther Agency Review or Permit Required Review or Receipt
of Permit VZrffled By Date
Florida Dept. of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineirrs
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
0Other.
APPLICATION STATUS
First Review: [DApproved. []Denied. DNot applicable
Reviewing Department
(Circle one.) Comments:
BUILDING
LANNING &ZONING Reviewed by: Date:
T 1 S
REEADMIN.
__..? ppr
_, Second Review: [:]Approved as revised. ElDenied. []Not applicable
ORK Comments:
ORK Co
numerills
L'J�"P'uveu as revise L-
8 UT ITIES
PUBLIC SAFETY Reviewed by: Date*_
FIRE SERVICES Third Review: E]Appmved as revised. oDenied. ONot applicable
Comments:
Reviewed by: Date:
Revised 05/1912017
CITY OF ATLANTIC BEACH
CONSTRUCTION PERMfT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
M Seodnoh�Road
Allenbc Exanch.Fkakla 32233-5445
Fax
PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH APPLICATION.
Date 08/0912017
Job Address 196 SEMINOLE RD
Permilee: JEA- BRIAN MIDIKIFF, MIDKBM(a)JEA.COM Telephone# (904) 665-7534
Pearniftes Address: 21 WEST CHURCH ST, JACKSONVILLE, FIL 32202
Requesting Permission to construct: INSTALL ONE�FOOT CLEARANCE POLE TO FUMSE SECONDARY CLEARANCE ABOVE STRE-ET
FEEDING HOUSES I So AND I N SEMINOLE RD
Location: (Reference to Cross-Street) SEMINOLE RD AND DAVID ST
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 an the sketches.
A Letter of Notification was mailed to the following Utilities/Municipalifies:
Jacksonville Electric Authority Yes I No (�) Date:
Bell South Telephone Company Yes No (e) Date:
Ferrell Gas Yes No IV) Date:
Comcast Yes No (e) Date:
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 TIMSES�� (Contractors Pmject
Superintendent)located at Telephone#:
4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designeae.
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. Calculations showing any increase in impervious area on owner's lot or in the city
Right of Way are to be Included with this application.
7. This pennuffee shall commence actual construction in good faith with x days. It the beginning date is
more than 60 days from date of Permit approval, then penniftee 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, fille 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 Aflantic Beach from and
against any and all loss, damage, and cost of expenses arising in any manner of the exercise or attempted
exencistas 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: Daw:
Belom me Mis day of_ln Me County of DmI,
SIGME Of Fikurida.ras Peraonuly appeend
NOW,P.1olim at Large.Stifte of Flofids.County.1 Do,nal
My conuniason expinus: ftsonelly K.:
Proaluced NeR_5�n:
ENGINEERING DESIGN
ORACLE PERMIT MA)UMO DATE REL
PROJECT N $003870 NO,: WO#. PERMIT COPY CONST.0117
CIR. TREE TRIMMING
SUE�STA:NEPTUNE BEACH NO.: 565 REDD:NONE
ENGINEER:BRIAN MIDKIFF CELL
N.O,: $62-8300 ZIP CODE: 32233
CUSTOMER1 SVC PHONE
LOCATION 196 SEMINOLE RD CENTER:SSSC N.O.:665-7534
INSTALL NEW 3514W POLE @ STA 1. SWING CUT-INS TO NEW POLE AND N
RUN 210P BACK TO TRANSFORMER POLE 183.
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ENGINEERING DESIGN
ORACLE PERMIT MAXIMO DATE REL
PROJECT# 8003870 NO.: WO t. PERMIT COPY CONST.0117
CIR. TREE TRIMMING
SUB-STA: NEPTUNE BEACH N.O.:565 REOD:NONE
ENGINEER:BRIAN MID�IFF CELL
NO,:502-9300 ZIP CODE: 32233
CUSTOMER/ Svc PHONE
LOCATION: 196 SEMINOLE RD CENTER: SSSC NO.:605-TS34
INSTALL NEW 35/4W POLE @ STA 1. SWING CUT-INS TO NEW POLE AND
RUN 2/OP BACK TO TRANSFORMER POLE 183. N
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ENGINEERING DESIGN
ORACLE PERMIT MAXIMO DATE REL
PROJECT# 8003070 N.O.: WO#; PERMIT COPY CONST 0117
CIR TREE TRIMMING
SUB-STA: NEPTUNE BEACH N.O.: $65 REaD:NONE
ENGINEER:BRIAN MIDKIFF CELL
N.O,:$624300 ZIP CODE: 32233
CUSTOMEN Svc PHONE
LOCATION: 196 SEMINOLE RD CENTER: SSSC N.O.:665*7SU
INSTALL NEW 35/4W POLE a STA 1. SWING CUT4NS TO NEW POLE AND
RUN 2/OP BACK TO TRANSFORMER POLE 183. N
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