HomeMy WebLinkAbout19-21505 CITY OF ZEPHYRHILLS /
5335-8TH STREET
(813)780-0020 505
BUILDING PERMIT
PERMIT INFORMATION' LOCATION INFORMATION
Permit Number: 21505 ' Address: 38522 A AVE
Permit Type: COMMERCIAL ZEPHYRHILLS, FL.
Class of Work: ADD/ALT COMMERCIAL Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: - Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 14-26-21-0010-01700-0060
Improv. Cost: 20,000.00 OWNER INFORMATION r`.
Date Issued: 7/19/2019 Name: CROWN CASTLE GT.COMPANY LLC
Total Fees: 310.00 Address: 4017 WASHINGTON RD
Amount Paid: 310.00 MC MURRAY, PA. 15317-2520
Date Paid: 7/19/2019 Phone: (813)342-3853
Work Desc: INSTALL AT &T ANTENNAS & GENERATOR 20 KW 90 GAL W/PAD
CONTRACTORS APPLICATION FEES
CROWN CASTLE USA INC BUILDING FEE 210.00
FIRE PERMIT FEES 100.00
Ins ections Required
FOOTER 2ND ROUGH PLUMB MI C INSULATI N CEILIN
FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute SS3.80(2)(c)the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe 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, state agencies or federal agencies.
"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."
Complete Plans,Specifications Must Accompany Application.All work shall be performed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
/711ATOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
Bldg Dept
From: Bldg Dept
Sent: Thursday,August 29, 2019 8:36 AM
To: 'Mary Watson'
Subject: RE: CONTRACTOR REGISTRATION - CONCURRENT GROUP LLC.
The electrical cost will be$65 to add to permit .We take payment check or cash and the company will need to sign onto
the permit application. We do not do this on line or through phone will have to stop by our office which is located at
5335 8th St 33542 at the building dept.
Thank you
Jackie Boges -
813-780-0020 ext 3513
"A rule I have had for years is:to treat the Lord Jesus Christ as a personal friend. His is not a creed, a mere doctrine, but it is He
Himself we have." Dwight L. Moody
Florida has a very broad public records law. Electronic communications regarding most City
of Zephyrhills business are public records and available upon request. Your e-mail
communications may therefore be subject to public disclosure. If you received this message in
error, please do not read, forward, copy, etc. and delete immediately.
From: Mary Watson<mary@concurrentgroupllc.com>
Sent:Wednesday,August 28, 2019 4:30 PM
To: Bldg Dept<BDept@ci.zephyrhills.fl.us>
Subject: RE:CONTRACTOR REGISTRATION-CONCURRENT GROUP LLC.
EXTERNAL EMAIL
The valuation for the Electrical is$5,000.
Let me know what else you need.
Thank you for all of your help.
Mary Watson
CONCURRENT
2774 Carrier Avenue
Sanford, FL 32773
407-585-4221 Office 407-361-5664 Cell
mary@concurrentgroupllc.com
i
Bldg Dept
From: Mary Watson <mary@concurrentgroupllc.com>
Sent: Thursday,August 29, 2019 11:26 AM
To: Bldg Dept
Subject: RE: CONTRACTOR REGISTRATION - CONCURRENT GROUP LLC.
EXTERNAL EMAIL
We will be sending our crew lead to pay for this. Can he sign the application?
Thanks,
Nary Watson 5 0 -�-
1
GONCURRENToo
2774 Carrier Avenue
Sanford, FL 32773
407-585-4221 Office 407-361-5664 Cell
mary@concurrentgroupllc.com
www.concurrentgrouplic.com
From: Bldg Dept [mailto:BDept@ci.zephyrhills.fl.us]
Sent:Thursday,August 29,2019 10:01 AM
To: Mary Watson<mary@concurrentgroupllc.com>
Subject: RE: CONTRACTOR REGISTRATION-CONCURRENT GROUP LLC.
I have it here in my office they can sign once paid .
Building Dept
813-780-0020
813-780-0021
Florida has a very broad public records law. Electronic communications regarding most City
of Zephyrhills business are public records and available upon request. Your e-mail
communications may therefore be subject to public disclosure. If you received this message in
error, please do not read, forward, copy, etc. and delete immediately
From: Mary Watson<mary@concurrenteroupllc.com>
Sent:Thursday,August 29,2019 10:00 AM
To: Bldg Dept<BDept@ci.zephvrhills.fl.us>
Subject: RE:CONTRACTOR REGISTRATION-CONCURRENT GROUP LLC.
EXTERNAL EMAIL
Will you please send me the application we need to sign or tell me where to get it, please.
1
r" City ofZephyrhills Permit Application Fax-813-780-0021
816298/14639419 - Building Department
Date Received Phone Contact for Permitting 813 342 3873
Owners Name Crown Castle USA Inc.for AT&T owner Phone Number 813-342-3873
Owners Address1 4511 N Himes Ave Ste 210 Tampa,FL 33614 Owner Phone Number
Fee Simple Titleholder Name I Crown Castle GT Company Owner Phone Number
Fee Simple Titleholder Address 4017 WASHINGTON RD PMB 353, MC MURRAY PA 15317-2520
JOB ADDRESS 38522 A Ave.,Zephyrhills, FL 33542 1 LOT# 6,7,&8
SUBDIVISION PARCEL to$1 14-26-21-0010-01700-0060
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW CONSTR ADD/ALT = SIGN = = DEMOLISH
INSTALL x REPAIR
PROPOSED USE = SFR = COMM = OTHER
TYPE OF CONSTRUCTION = BLOCK = FRAME 0 STEEL =
AT&T proposingl0 antennas @ 215',6 Power and 3 Fiber cables,and 12 RRUS.Proposing to install a 10'x 15'with 8'x 14'
DESCRIPTION OF WORKfnr
BUILDING SIZE SQ FOOTAGE= HEIGHT
=BUILDING $20,000 VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C.
=PLUMBING $
r �06 A
=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
=GAS = ROOFING 0 SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
BUILDER �f " COMPANY Crown Castle USA, Inc
SIGNATURE V`� REGISTERED I Y/ N FEE CURREN Y/N
Address 4511 N.Himes Ave,Ste 210 Tampa,FL 33614 License# SCC131152078
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y/ N FEE CURREN I Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED I Y/ N FEE CURREN Y/N
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED I Y/ N FEE CURREN I Y/N
Address License#
OTHER COMPANY
SIGNATURE REGISTERED I Y/ N FEE CURREN LXLN
Address License#
1111111111111111111111111111111111111111111111111111111111111111111
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stornwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster,Site Work Permit for subdivisions/large projects
COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stornwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY required for all NEW construction.
...r...r�...r�...r...rl..t-i..l--�L-1..�:�...-�...r .—�
Directions:
Fill out application completely.
Owner&Contractor sign back of application,notarized
If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500)
Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs if shingles Sewers - •Service Upgrades A/C Fences(Plot/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
1
�-` 816298_89059
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work,they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work,they are advised to contact the Pasco County.Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the"contractor Block"of this application for which they will be responsible. If you, as the owner sign as the
contractor,that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings,change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands,that such fees, as may be due,will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a"certificate of occupancy"or final power release. If the project does not involve a certificate of occupancy or
final power release,the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended): If valuation of work is$2,500.00 or more,I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowners
Protection Guide"prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the"owner",I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the"owner"prior to commencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating construction,zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other government agencies may apply to the intended work,and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls,Docks,Navigable Waterways.
- Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
- If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume"will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
- If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction,I certify that fill will be used only to fill the area within the stem wall.
- If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties,the owner may be cited for violating
the conditions of the building permit issued under the attached permit application,for lots less than one(1)
acre which are elevated by fill,an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER,I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate,cancel,alter,or
set aside any provisions of the technical codes,nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans,construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six(6)months after the time the work is commenced. An extension
may be requested, in writing,from the Building Official for a period not to exceed ninety(90)days and will demonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
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 T9_OqTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTI OF MMMENCEMENT.
FLORIDA JURAT(F.S.117.03
OWNER ORAGENT�/v � CONTRACTOR
Sub c*,b and sworn t (o ffi f bef a me this -Subscrib@d and orn to te{n hi
] ILI by keytn n 4J02
Who istare personally known to me or has/have produced Who i ar ersonally kno to a or has/have produced
as identification. as identification.
Notary Public U Notary Public
Commission No. Commission No.
Aw Lie V.^ OLt-nJert-N
Name o Name of Notary typed,printed tamp "'�.,, GALE LOGAN
ati►Ry ooe•. ALEX LEE VAN VLAENDEREN MY COMMISSION#GG 121026
Notary Public State afFlorid� :a: 'ems EXPIRES:July4,2U21
tee` Commission#GG 245273 s'.nBondedThruNot"PublicUrxleWters
1orr�°i` My Comm.Expires Aug 2,2022
Banded through National Notary Assn.
CITY OF ZEPHYRHILLS
5335_8TH STREET
(813)780-0020 21505
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 21505 Address: 38522 A AVE
Permit Type: COMMERCIAL ZEPHYRHILLS, FL.
Class of Work: ADD/ALT COMMERCIAL Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 14-26-21-0010-01700-0060
Improv. Cost: 25,000.00 OWNER INFORMATION
Date Issued: 7/19/2019 Name: CROWN CASTLE GT COMPANY LLC
Total Fees: 375.00 Address: 4017 WASHINGTON RD
Amount Paid: 375.00 MC MURRAY, PA. 15317-2520
Date Paid: 9/05/2019 Phone: (813)342-3853
Work Desc: INSTALL AT &T ANTENNAS & GENERATOR 20 KW 90 GAL W/PAD &ADD ELECT
CONTRACTORS APPLICATION FEES
CROWN CASTLE USA INC BUILDING FEE 210.00
CONCURRENT GROUP LLC FIRE PERMIT FEES 100.00
ELECTRICAL FEE 65.00
Ins ections Required
FOOTER 2ND ROUGH PLUMB MIS INSULATION CEILING
FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe 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, state agencies or federal agencies.
"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."
Complete Plans,Specifications Must Accompany Application.All work shall be performed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
C R SIGNATURE PERMIT OFFI R
7PERMIT EXPIRES IN f MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CROWN Crown Castle
CCCASTLE 4511 North Himes Avenue,Suite 210
Tampa,FL 33614
Date: 1/23/19
Municipality: City of Zephyrhills
Name of license holder: Adam Ehrlich
County Certificate # or State License# SCC1 31 1 52078
The following person(s) are authorized to sign for permits for the above referenced license holder.
All person(s) authorized to sign must produce a valid Driver's License or Government issued photo
ID card and a Photo with this application. This Authorization is for All Permit Submittal and Permit
Pickup.
Names: Please Print Driver License
Kevin DePatie D130-517-78-128-0
Alex Van Vlaenderen V514-012-91-248-0
Terri Anello A540-800-70-784-0
Trisha Purcell P624-801-81-850-0
Jeff Stephens 1309685 (Northern Territory of Australia)
Deborah platthy P430-170-61.589.0
Authorization to s re good 12 months of dated form.
(Signat - Contracto
Commonwealth of Pennsylvania
COUNTY OF
Sworn to(or affirmed)and subscribed before me this ti day of Jan ,-7 (year),
by °� L'f 1 G�, (name of person making
statement).
(Signature of Notary Public-State of Florida) GALE LOGAN
€. � COMMISSION ft GG 121026
EXPIRES;July 4,2.021
(Print,Type,or Stamp C mmissioned Name of Notary Public) shfP�`' 0ordadTbru t°t'pub{iCUnaenvd["
Personally Known OR Produced Identification
The Foundation for a Wireless World.
CrownCastle.com
CROWN Crown Castle
CCASTLE 4511 North Himes Avenue,Suite 210
Tampa,FL 33614
Date: 1/23/19
Municipality: City of Zephyrhills
Name of license holder: Adam Ehrlich
County Certificate # or State License# SCC1 31152078
The following person(s) are authorized to sign for permits for the above referenced license holder.
All person(s) authorized to sign must produce a valid Driver's License or Government issued photo
ID card and a Photo with this application. This Authorization is for All Permit Submittal and Permit
Pickup.
Names: Please.Print Driver License
Kevin DePatie D130-517-78-128-0
Alex Van Vlaenderen V514-012-91-248-0
Terri Anello A540-800-70-784-0
Trisha Purcell P624-801-81-850-0
Authorization fo s re good 12 months of dated form.
(Sig nat Contracto.
Commonwealth of Pennsylvania
COUNTY OF cb/'o(��rA
Sworn to (or affirmed) and subscribed before me this v day of ,J C4n (year),
by �. L'`� c G/1, (name of person making
statement).
(Signature of Notary Public-State of Florida) � :�►��: �;. GALELOGAN
MY COMMISSION Al GG 121026
_.+ oaf EXPIRES;July 4,2021
(Print,Type,or Stamp C mmissioned Name of Notary Public) Rft SandedThruNOMPublicUnderwMms
Personally Known OR Produced Identification
The Foundation for a Wireless World.
CrownCastle.com
CONCURRENT
LIMITED POWER OF ATTORNEY
Date: 9-5-19
I hereby name and appoint Philip Shglpe to be my lawful attorney
in fact to act for me and apply for a permit and to sign on my behalf do all things necessary to be
performed for work at 38522 A Avenue, Zephylhills, FL
Licensed Contractor: Fernando Munilla
License Number: EC13008099
Signature 0��I
STATE OF FLORIDA, COUNTY OF Seminole
Affirmed and subscribed before me that 5th day of September 2019_
by Fernando Munilla who is personally know to me or who has produced
(type of ID) identification
Signature of N tary Public State of Florida
Mary B Watson
Print Name of Notary
Notary Public State of Florida
Mary B Watson
My Commission GG 106952
Expires 12/06/2021
135-G SW 47 Street Miami, Florida 33155
' 1 •.• 1 ! F:305-669-5501 concurrentgroupllc.com
Crown Castle USA, Inc
Adam K Ehrlich
4511 N. Himes Ave,Ste 210
1601 NW 136 Ave
Tampa, FL 33614 SCC131152078
(813) 342-3852 Sunrise, FL 33323
561-922-1230
NFLpermits@crowncastle.com
0
FLA'4�fu`A
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner:
Date Received:Site:
Permit Type:
Approved w/no comments:❑ Approved w/the below comments: Denied w/the below comments: ❑
This comment sheet shall-be kept with the permit and/or plans.
JUL 12 2019
zo< -
witzer—Plans Examiner Date Contractor and/or Homeowner
Kar
(Required when comments are present)
Cl ----V City of Zephyrhills Permit Application Fax-813d80.0021
8162 9 8/14 6 3 9'4 79. Building Department
Data Received' .Phone Contactfor Pennittl,, 813 342 3673
t-IT7-T' -rrrr�r. -T-TI
owners Name .Grown Castle US-A.Inc.for-AT&T owner Phone Number 813-342-3873 �
Owners Addres& 4511 N Miles Ave Ste 210 Tampa, 4 Owner Phone Number
Fee Simple Titloholder Name Crown Castle GT Company Owner Phone Number
Fee Simple Titleholder Address, 4017 WASHINGTON.RD PM13353,MC MURRAY PA.153172520
JOB ADDRESS 38522 A Ave.,Zephyrhills,•FL•33542• LOT#
SUBDIVISION PARCEL ID# 14-26-21-0010-01700-0060
IOBTNNEO FROM PROPERTY TAX NOTICE) '
WORK PROPOSED e NEW CONSTR ADDIALT = SIGN Q 0 DEMOLISH
INSTALL x REPAIR
PROPOSED USE = SFR Q COMM = OTHER
TYPE OF CONSTRUCTION = BLOCK Q FRAME Q STEELED
TAT proposingl0 anlennas @ 215',6 Power and 3 Fiber cables,and 12 RRUS.Proposing b Install a IV x 15.anth V
DESCRIPTION OF WORK
BUILDING SIZE SO FOOTAGE= HEIGHT C�
=BUILDING: 520,000 VALUATION OF TOTAL CONSTRUCTION j
i
=ELECTRICAL S AMP SERVICE = PROGRESS ENERGY = W.R.E.C. .,
=PLUMBING •J 7 K
=MECHANICAL $$ VALUATION OF MECHANICAL INSTALLATION
=GAS Q ROOFING Q SPECIALTY = OTHER 1 Y'p V1"�✓
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 ... . 9 , 1 1 1=YES NO
. . , — . . .-S,.I-f-i ;-SL - � . 1 ; 11 ,
y„y-,. . . . . . . ..
BUILDER f`I i, " COMPANY Crown Castle USA, Inc
SIGNATURE I YIN I FEECURREN Y/N'
Address 14611 N.Himes Ave,Ste 210 Tampa,FL 39614 Licensed SCC131152078
. I
ELECTRICIAN COMPANY GLt.I /r✓fv'— Gi-Oct LL
SIGNATURE 1 // ! u [ �M REGISTERED Y/N FEEcuRm Yp/N 6 C
Address 7Q3S-6 Sw 7 7J1 ir(lArr License# C+ C /✓-0V p U /
PLUMBER. COMPANY
SIGNATURE I YIN FEE CURREN I Y/N
Address Llrense#
MECHANICAL COMPANY
SIGNATURE REGISTERED I Y/N FEE CURREN Y/N
Address License A
OTHER COMPANY
SIGNATURE REGISTERED - YIN -FEE CURREN 'Y/N
't
Address License# i
II-I.I11111111111'111111111111111tIII II1111111111111111111111111111111
RESIDENTIAL Attach'(2)Plot Plans;(2)sets of Building Plans:(1)set of Energy Fortes:R-0-W Permit for.new construction,
Minlrn6rn ten(10)working days after submiltal date.Required onsile,ConstructionPlans,Stermwater Plans w/Silt Fence Installed,
Sanitary Facllilles&1 dumpsler,Site Work Permit for subdvisionsnarge projects
COMMERCIAL 'Attach(3)complete sets of Building Plans plus a Life Safety Page;(1),sel of Energy Forms.R-O-W Permit for new construction.
Minimum,len(10)worldng days after submittal dale.Required onsite,Construction Plans,Stormwater Plans w/Silt fence installed,
Sanllary:Facllitles&1.dumpsler.Sile'Work Permit for all hew projects.All commercial requirements must meet compliance_
SIGN PERMIT Attach(2)sets of Engineered Plans.
PROPERTY SURVEY regolred for all NEW construction.
Directions:
Fill '
Fill out app6ca6on completely.
Owner&Contractor sign back of application,notarized
If over$2600,a Notice of Commencement Is requlred. (A/C upgrades over$7600)
Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from ownerauthorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs if shingles Sewers• •Service Upgrades A/C Fences(PloUSurvey/Footage)
Drtvow&ys-NOl over Counter lion public roadways..needs ROW
I
I
INSTR#2019145557 OR BK 9963 PG 1 Q73 page 1 Df 1
•0812712019 03:51 PM Rcpt:2085202'Rec:10.00 DS:0.00 IT:0.00
Nikki Alvarez-Sawtes,Esq.,Pasco County Clerk&Comptroller
816298J2463W9 j
i
PoWiNo. '21605 ParceliDNO 14-2&21-0010,01700-0060-
i
NOTICE OF COMMENCEMENT
i
Slate of Florida Countyai Pasco
THE UNDERSIGNED hereby gives notice that improvement wd is made to certain teat property,and_In accordance with Chopiar.713,Florida Statutes,
the following information is provided in this Notice of Commencement: !
1. Description of Property:Parcel Identification 1,10.1446-21-0010.01700.0060 Moores First Addillon To CRy OFZeph rhills,PS 1 Pg 57
StmolAddross:38622 A Ave.,Zephyrhills,FL 33542 ��6,7;&e Inclusive Bldc 17 OR 4639 PG 280
2. General Description of Improvement NS9 for AT&T-Propose 10 antennas la 2I5'"3 DC-6 6 bCrs 6 Power and-3 Fiber cables 3 RRUS 85/812
'4449,3 82l856A 8843;3 RRUS-32,3 RRUS 814447&101x 15'with 8'x 14'pad for and a shelter and generator. I
3. Owner information or Lessee Inferm�togon if the Lessee contracted for-the Improvement: t
Crown Castle USA Inc. Pert A••W
Name
d511 N-H_imes Avenv_a Cnite?1D Tampa PA
Address City State
Interest In Propany: Tower'Owner
i
Name of Fee Simple Titleholder f
{if di9erem from Owner listed above)
4• Cddresstor Crown Castle USA Inc. City State "
4511 N.Himes Avenue,Suite 210 Tampa FL
Address 407-585-0220 City Stale
Contractols Telephone No.:
S. Sumy: NIA
Name
Address City .State
AmountofBond:3 Telephone No.:
9. Lender."NSA _ I
Name
Address city State
Lenders Telephone No,:
7. Persons within the Slate of Florida designated by the owner upon whom notices or other documents may be served as provided by
�Aan 713.13(1)(a)(7),Florida Statutes:
Nome
Address City State
Telephone Number.oi Designated Person:
i
8. in addition to himself,the owmardestgnates N fA of-
to receive a copy of the Uenors Notice as provided In Section 713.13(1)(b),Florida Statutes.
Telephone Number of Person or Entity Des ifnatod by Owner-
8. E:tyirotion dale of Notice of Commencement(the Wfratlon date-may not be before the completion of construction and final payment to the
contractor,but Will be one yoarfrom the date of recording unless a different dale Is spodfierl): -
WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPiRAMON OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER'PAYMENTS UNDER CHAPTER713.PART1,SECTION713.f3" FLORIDA STATUTES,AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICC OF COMMENCEMENT MUST BE I
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 COMMENCING WORK OR RECORDING YOUR N0710E OF COMMENCEMENT.—
Under penalty of perjury,I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best
of my knowledge and belief.
STATE OF FLORIDA
pAse-D
COUNTY OF PA900 Hillsborough -
Slgnetumr of Owner or Losses,or Owner's or Lessee's Authorized j
OfficerlDiredonpadne�d1 tanager I
` Signatorys 1letOafce t
dual Sndat•:I
The foregoing Instrument was aclatovledged befq)e rpa 1hi ,�dtry at 20 jq,by- t---
s_ 17r0ittf ( (type of authority,a.g.,officer,trustee,attorney In fact)for
Crct`ari C c}kkL i TSk.Tut I • ZrA`tf+,-R �(na-s of hat tnstnunant xas executed).
r f
Personally Knorm DO OR Produced ideetificallon E3 Notary Signature f„r !
Type of Identification Produced -Name(Prtnt) t s
1
..►' MICHELLE M.RODRiG.UEP DKZ )
- -.-_-- MY COMM 66tt)N q GG047578 "
ter.•.' e,a�,.,• EXPIRE®November 15,8020: - .
i5pdetatixatno8cecamiciancament,,,pc053048" _- - - - -- -" --i --
I
STATE OF FLORIDA, COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING IS A ,r "''' °
TRUE AND CORRECT COPY OF THE DOCUMENT
Oil FILE OR OF PUBLIC RECORD IN THIS.OFFICE
D OFFICIAL AL T S ` �
WIT Y'NAND
DAY 0 a :-. f.. •>. ,«
CLE COMPTROLLER
BY DEPUTY CLERK