380 12th St ROW19-0022 Install 35-ft Pole RIGHT OF WAY PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ROW19-0022
ISSUED: 7/24/2019
800 SEMINOLE ROAD
EXPIRES: 10/22/2019
ATLANTIC BEACH. FL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts,state agencies, or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
380 12TH ST RIGHT OF WAY SINGLE OR TWO install new 35-ft. pole $0.00
FAM I LY RIGHT OF WAY
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1719300000 SELVA MARINA UNIT 01
COMPANY: ADDRESS: CITY: S MATE
JEA
OWNER: ADDRESS: CITY: STATE: ZIP:
PETER & AMY POLLAK 380 12TH ST ATLANTIC BEACH FL 32233-5514
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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.
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
I I PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
2 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration,including sod,is required.
Issued Date: 7/24/2019 1 of 2
RIGHT OF WAY PERMIT PERMIT NUMBER
ROW19-0022
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 7/24/2019
—0ji 9' ATLANTIC BEACH. FL 32233 EXPIRES: 10/22/2019
3 PUBLIC WORKS RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
4 PUBLIC WORKS ADDITIONAL COMMENTS PUBLIC WORKS INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
5 PUBLIC UTILITIES 7_UNDERGROUND WATER SEWER UTILITIES INFORMATIONAL
Notes:
Avoid damage to underground water and sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field
coordination is needed,call 247-5878.
6 PUBLIC UTILITIES UTILITY MAP INFORMATIONAL
Notes:
See attached Utility Map.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
TOTAL:
Issued Date:7/24/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department ECIE, (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826- Fax(904)2 ?78JUL 18 2019
1� oil E-mail: building-dept@coab.us L Date routedi
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:' 1,) 0 0 Department review required Yes No_
B�j�in
Applicant: Q�Inning &Zon7ing�
Tree Administrator
Project: 'I
"4ublric WUtilities
PubTic---Sa�ety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: VApproved. []Denied. E]Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed te:
TREE ADMIN. Second Review: []Approved as revised. FIDenied. E]Not applicable
Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. [:]Denied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 lei —ob-
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:' Q 00 J Department review required Yes No
Buildipg_.
Applicant: M1111M
Tree Administrator
Project: <_Public Works
Public Utilities
_1�6blic Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcollolic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: ,_�pproved. ElDenied. []Not applicable
(Circle one.) Comments:
BUILDING _�A f trf e
Reviewed by: Date:-
TREE ADMIN. Second Review: ElApproved as revised. F]Denied. E]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ElApproved as revised. []Denied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05119/2017
;r'. City of Atlantic Beach APPLICATION NUMBER
or Building Department (To be assigned by the Building Department.)
-P 800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://vmw.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:. 3 W Department review required Yes No
B u i"n
Applicant: X Q§nning &Zoni!Cg
Tree Administrator
< ublic 6rk
Project: I s
lic Otitfw__
_f5—ublic SaTe—ty
Fire-Serv-ices
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLIC N STATUS
Reviewing Department First Review: pproved. E]Denied. E]Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed bv: Z e�n�11��ate: 7-Z
TREE ADMIN. Second Review: F
]Approved as revised. OlDenied. F]Not applicable
PUBLIC WORKS Comments:
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. E]Denied. F]Not applicable
Comments:
Reviewed by: Date:
Revised 05/1912017
PUBLIC UTILITIES PLAN REVIEW COMMENTS
Date: -7 Application#:
Project Address: 12-
Check Box Check
APPLICATION TRACKING COMMENTS to Add Box to
Commen�, rint
Underground Avoid damage to underground water and sewer utilities. Verify vertical and
Water Sewer horizontal location of utilities. Hand dig if necessary. If field coordination is
Utilities needed, call 247-5878.
Meter Boxes Ensure all meter boxes, sewer cleanouts and valve covers are set to grade
Sewer Cleanout and visible. 13 E3
A sewer cleanout must be installed at the property line. Cleanout must be
RT1 Sewer covered with an RT1 concrete box with metal lid. Cleanout to be set to grade 13 0
Cleanout and visibi . i
A reduced pressure zone backflow preventer must be installed if irrigation will
RPZ be provided or if there is a private well on the property. Backflow preventer 13 13
Backflow must be tested by a certified tester and a copy of the results sent to Public
Utilities.
Plans note the building will be unsprinkled. If plans change, any fire line
Sensus installed must be metered with a Sensus touch-read meter in a properly sized
Touch-Read vault and an appropriate backflow preventer installed. Backflow preventer 0 0
Meter must be tested by a certified tester and a copy of the results sent to Public
Utilities.
Fire Sprinkler If fire sprinkler system is provided,call 247-5878 for backflow requirements.
Backflow At a minimum,will require a double check backflow preventer. 0 13
Requirement
Fire Line Fire lines must be metered with a Sensus touch-read meter. Meters larger 13 0
Meter than 2" must be installed in a vault as noted in JEA specifications.
Utility Map See attached Utility Map.
Disconnect Disconnect and cap water and sewer lines. 0 0
&Cap
Inspection Must call the Inspection Line at 247-5814 to request an inspection of the 0 0
Prior disconnected and capped water and sewer lines prior to demolition.
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SEWER MAIN
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ENGINEERING DESIGN
ORACLE PERMIT MAXIMO DATE REL
PROJECT#:39372 N.O.: 8005212 WO#.- 30456618 CONST 07112119
CIR. TREE TRIMMING
SUB-STA: NEPTUNE BEACH N.O.: 563 REQ'D:YES
CELL
ENGINEER: Robert Simpson N.O.: N/A ZIP CODE: N/A
CUSTOMER/ Svc PHONE
LOCATION. 380 12TH STJ 3514W INSTALL 563 CENTER: SSSC N.O.:665-7793
%
STA 1, P# 388 12TH STJ INSTALL
/t35/4W, RUN 4/OP TO STA 2.
STA 2, P# 393 12TH ST.
TREE REMOVAL REQUIRED
NEW HOME BUILD
STA 1
004, 4W C�o 370
35L
359 35�
4/0 4
393
SOB
4W
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A
RIGHT-OF-WAY/EASEMENT PERMIT APPLICATION "ALL INFORMATION
City of Atlantic Reach HIGHLIGHTED IN GRAY 15
800 Seminole Road,Atlantic Beach,FL 32233 REQUIRED.
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
Job Address- 3 91 o I S)17 Permit Number
Contractor Information
Company Qualifying Agent
Address City__:EgX_State_)El_
Phone Email
State Certif ication/Regist ration#
Architect Phone Email
Engineer Phone E m a i 19,'0,,0 12 d
Workers Compensation lnsurer[71.-.. OR ExemptElExpiration Date
• Permittee declares that prior to filing this application they have ascertained the location of all existing utilities,both aerial
and underground and the accurate locations are shown on the sketches.
• 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 Public Works Director,any or all 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 Public Works Director and at the expense of the
Permittee unless reimbursement is authorized.
All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the
supervision of (Project Superintendent)
with(Company Name) Phone
All materials and equipment shall be subject to inspection by the Public Works Director.
All city property shall be rest ored to its original condition as far as practical, in keeping with City specifications and the
manner satisfactory to the City.
• 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.
• The permittee shall commence actual construction in good faith within days. If the beginning date is more than 60
days from date of permit approval then permittee must review the permit with the Public Works Director to make sure no
changes have occurred in the area that would affect the permitted construction.
• It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right,
title 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 Atlantic Beach from and against any and all loss,damage and cost of
expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges.
r shall be notified 24 hours prior to starting work and again immediately upon co pletion.
m
Date 9,6 7,// 3
Permittee(signed in presence of Motary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this_day of .20_
by who personally appeared before me and
(printed name of Permittee)
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it.
Personally Known
Signature of Notary Public,State of Florida Produced Identification(Type)
H:\Applications&Forms\Word Documents\201801001 Right-of-Way Easement Permit Application.docx Revision Date:10/1/18
CUE Reports
Estimate Number:39372 380 12TH ST.351W INSTALL Estimate Type:SR Contract:089-16-HM OH FY19
Estimate Version: By: SIMPRB
MWO#[Task:30456618 Required Date:
Oracle Project#:8005212 Estimated On: 07/12/2019
- Cost Estimate
Materials JEA Contractor
1.New Material Cost(w/sales tax) $459.13 $459.13
2.Transformer Cost(w/sales tax) $0.00 $0.00
3.Returned Material Salvage Value $0.00 $0.00
Labor
4.Crew Time $302.25 $808.32
5.Extraordinary Costs $0.00 $0.00
JEA Overhead
6.Fringe Benefits(43.52%of lines 4&7) $168.31 $98.32
7.Engineering Costs(Variable%of line 4) $84.48 $225.93
8.Project Equipment Costs(40%of total equipment costs) $174.46 $0.00
9.Material Handling(6.67%of lines 1 &2) $30.62 $30.62
10.Inspection(6.84%of line 4) $0.00 $55.29
11.Total Cost of Project $1,219.25 $1,677.61
12-Work Order Estimate(Line 11 minus line 8,9.&10) $1,014.16 $1,646.98
13.Billable Equipment Depreciation(60%of total equipment costs) $261.69 $0.00
14.Billing Estimate(including Transformer Cost)(Lines 11+ 13+(64.49%of 4&7)) $1,730.35 $1.823.31
15.Billing Estimate(WIO Transformer Cost)(Lines 11 +13+(64.49%of 4&7)-Line 2) $1.730.35 $1,823.31
Time Estimate
Crew Hours Total Manhours
2.42 9.69
-----------------------------------------------------------------------------------------------------------------------------------
CUE Reports
Estimate Number:39372 380 12TH ST-351W INSTALL Estimate Type:SIR Contract:089-16-HM OH FY19
Estimate Version: By: SIMPRB
MWO#rTask:30456618 Required Date:
Oracle Project#:8005212 Estimated On: 07/12/2019
CU Detail
Station: 01 388 12TH ST.
Build Transfer Remain in Place Remove
CAMP 60
G3W*2 1
GY3*5 1
P.35/4W 1
S4*4/0 1
Build Transfor Remain in Place Remove
RUBUP 2
S20ES*4/0-2/0 2
S4*4/0 1
S9*4/0 2
RUBDOWN 2
CUE Reports
Estimate Number�39372 380 12TH ST.35/W INSTALL Estimate Type:SR Contract:089-16-HM OH FY19
Estimate Version: By, SIMPRB
MWO#/Task-30456618 Required Date:
Oracle Project#:8005212 Estimated On: 07/12/2019
Conductor, Conduit and Pipe Detail
Quantities
From Station To Station CU Build Transfer Remain Remove
01 2 C.4/OP 60 0 0 0
JU 01 CUE Reports
Estimate Number:39372 380 12TH ST.35M INSTALL Estimate Type:SR Contract:089-16-HM OH IFY 19
Estimate Version: By: SIMPRB
MWO#/Task:30456618 Required Date:
Oracle Project#:8005212 Estimated On: 07/12/2019
Material Summary
Item Quantity Item Number Item Description
1 ANCSS002 ANCHOR, SCREW, SINGLE-HELIX, GALVANIZED 10"X 8'X 1-1/4", SHIP
ON OPEN FLATBED ONLY!
1 BOLMS036 BOLT, MACHINE, 3/4"X 14", SQUARE HEAD GALVANIZED STEEL,
W/SQUARE NUT ATTACHED, (MUST BE SHIPPED IN STD. BOX
QUANTITIES OF 25 EACH)
60 CA10SO03 CABLE,4/0-19(PAP), OVERHEAD SERVICE DROP, 600 VOLT
MULTIPLEX CABLE"VICKSBURG" PRE-ASSEMBLED PARALLEL 1000
FOOT REELS
I CLAGRO01 CLAMP, GROUND ROD, 5/8"-4SOL "HAMMERLOCK"
2 CLASR002 CLAMP, STRAIN RELIEF WEDGE,ALUMINUM, 1/0 TRI -4/0 PAP
2 CLASS006 CLAMP, STRAIGHT STRAIN, ALUMINUM, 10000#3/0- 556 ALUM (STD
PKG 15 EA)
3 CNNCP002 CONNECTOR, #2, 6-2 MAIN, 2-110 TAP,ALUMINUM COMPRESSION,
PARALLEL TAP,
6 CNNCP006 CONNECTOR,#6, 1/0-2/0 MAIN, 3/0-4/0 TAP COMPRESSION,
PARALLEL TAP, ALUMINUM,
4 CNNCP007 CONNECTOR,#7, 3/0-4/0 MAIN, 3/0-4/0 TAP COMPRESSION,
PARALLEL TAP,ALUMINUM,
2 CNNVG003 CONNECTOR, 6-2 SOL/10-2 SOL,VISE GRIP PARALLEL, BRONZE
16 COBC0028 CONDUCTOR, #4 SOLID, SOFT DRAWN, BARE COPPER, 200', 25#,ON
PLASTIC REEL, 4"X 11.5"W/2" HOLE
70 COBCW014 CONDUCTOR, #4,TYPE 40 DSA, COPPERWELD& COPPERWELD-
COPPER .204" DIAMETER 1480#BREAKING STRENGTH ( 50#COIL-
427' )
12 COVIC002 COVER,"D" DIE, INSULATING, 2-1/2"
1 GUAGWO01 GUARD, GROUND WIRE, 112"X 112"X 96", GRAY PLASTIC
1 GUAGWO02 GUARD, "YELLOW", GUY WIRE, 1/4"TO 112"8% POLYETHYLENE, USED
ON ALL 3/8"AND 7/16" GUY STRANDS (DISTRIBUTION)
1 GUYAT008 GUY HOOK, COMBINATION, MALLEABLE OR DUCTILE IRON, HOT DIP
GALV. 13/16" MOUNTING HOLE, 20,000 LB MIN. ULT. STRENGTH. FOR
WOOD OR CONCRETE POLES
2 GUYGRO01 GRIP, GUY, 3/8", 26", GALVANIZED
50 GUYST005 STRAND, GUY, 3/8"DIA, 7 PER STRAND, GALVANIZED STEEL, CLASS
"B" GALV. OR BEZINOL IS ACCEPTABLE (500'COIL)
1 INSGBOO2 INSULATOR, STRAIN, GUY BREAKER, 21,000#RATED, 60" ROD
LENGTH, FIBERGLASS FOR USE ON JEA'S DISTRIBUTION SYSTEM
ONLY
2 INSSU002 INSULATOR, SUSPENSION, 4", CLASS 52-9 NEMA STRENGTH 10000#,
GALV. FITTINGS
1 POLWO003 POLE, WOOD, 35'CLASS 4 (T/L =44), WEIGHT=1,026 LBS
1 RODGRO03 ROD, GROUND, THREADLESS, 5/8"X 8% SHIP ON OPEN FLATBED
ONLY!
2 SLEFT006 SLEEVE,4/0 7-STR AAAC, FULL-TENSION ALUMINUM, COMPRESSION
TYPE
1 TAGH0007 ALUMINUM VERTICAL TAG HOLDER FOR ADHESIVE BACK
CHARACTERS((NOT FOR"SLIDE IN"CHARACTERS)). 19.5" HIGH X 2"
WIDE WITH 3-1/8" NAIL HOLES @ THE TOP AND THE BOTTOM. (PKG.
Jr-A CUE Reports
Estimate Number:39372 380 12TH ST.351W INSTALL Estimate Type:SIR Contract:089-16-HM OH FY19
Estimate Version: By: SIMPRB
MWO#[Task:30456618 Required Date:
Oracle Project#:8005212 Estimated On: 07/12/2019
OF 50 EACH)
1 WASRD005 WASHER, ROUND, 3/4"BOLT SIZE X 2" DIAMETER, GALVANIZED,
500 EACH PER BOX ***
1 WASSF003 WASHER, SQUARE FLAT, 3" SQ X 1/4", 5/8"X 3/4" BOLT SIZE,
GALVANIZED
1 WASSP002 WASHER, SPRING, 3/4" BOLT SIZE, DOUBLE COIL HELICAL TYPE,
GALVANIZED (EXTRA HEAVY DUTY)
CUE Reports
Estimate Number:39372 380 12TH ST.35/W INSTALL Estimate Type:SIR Contract:089-16-HM OH FY19
Estimate Version: By: SIMPRB
MWOWTask:30456618 Required Date-
Oracle Project#:8005212 Estimated On: 07112/2019
CU Summary
CU Name Quantity DescriotIon
C.4/OP 60 4/0 AAC PAP W/4/0 AAAC NEUTRAL
G3W*2 1 WOOD POLE- NON-EQUIPMENT GROUND
GY3*5 1 GY3*5 3/8" DOWNGUY W/8 FT SCREW ANCHOR
P.35/4W 1 35 FT. CLASS 4 WOOD POLE
RUBLIP 2 LINE RUBBER INSTALLATION, PER SECT.
S20ES*4/0-2/0 2 SECONDARY CONNECTION AT POLE
S4*4/0 2 SECONDARY DEADEND
S9*4/0 2 SECONDARY SPLICE
M.- 6.4WA.W-6
CU Name Quantity Description
RUBDOWN 2 LINE RUBBER REMOVAL, PER SECT.