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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 826548/TA70XC110 Bu�ng Department Date Received � J �7 " �� /��C � Phone Contact for Permitting 813 34Z -- 3852 —T—i—�ITI-1 r r Owner's Name CCTMO LLC(Crown Castle) Owner Phone Number $13-342-3852 Owner's Address 4511 N. Himes Avenue,Suite 210,Tampa, FL 33614 pWner Phone Number � Fee Simple Titleholder Name City of Zephyrhills Owner Phone Number Fee Simple Titleholder Address 5335 8th Street,Zephyrhills, FL 33542-4312 JOB ADDRESS 38122 Henry Drive,Zephyrhills, FL 33542 LOT# � SUBDIVISION Tyson PARCEL ID# 02-26-21-0080-OOA00-0070 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED e NEW CONSTR e ADD/ALT 0 SIGN Q Q DEMOLISH INSTALL REPAIR PROPOSED USE Q SFR Q COMM � OTHER TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q Sprint 2.5 rework project:Proposing to install 3 AW3286 antennas,3 Nokia radios,3 cat 5's,1 power,3 fiber and 1 conduit. DESCRIPTION OF WORK The cat 5's and fiber will be inside the conduit on the tower.Power will be external on the tower.1 Junction box will be added. BUILDING SIZE SQ FOOTAGE� HEIGHT � �BUILDING $ 20,000 VALUATION OF TOTAL CONSTRUCTION OELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. 0 PLUMBING $ J�,(/I�11G�7/ � 1 � r, � � ��s �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � Q %_ �.( _�Gj�a��Jj�Z� l�«-ln��,� � ��.rd� �GAS 0 ROOFING Q SPECIALTY 0 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO� �� . . . , . . . . . .-. . . . , •�F�—' F-�--F�--r�7—i�i-�C—i—��i--F�7—C—i�C--�--Fi--i�� __ .—�--rG--Frir-i-�i—� _._---_— .. / ,`� � t ecommunications ec nica ervices ' BUILDER l �l �oCp+�� COMPANY Jason Darrell Gillis - � SIGNATURE p GL�f REGISTERED `�,Y/ N FEE CURRE�!'�� Y/N Address 5 Industrial Trace Alpharetta,GA 30004 �icense# CGC1522704 E�lz� , � , -� ' � ��1- s � ECTRICIAN -�'. � �� COMPANY r � C—� a�O�� SIGNATURE � ��'' �� REGISTERED Y/ N FEE CURRE� Y/N 3- o-�� Address License# PLUMBER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N � Address License# MECHANICAL COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# OTHER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# 1111111111111111111111111111" IIIIIIIIIIIIIIIIIIIIIIIItllllllllllllll RESIDENTIAL Attach(2)Plot Plans; (2)sets of Building Plans; ('I)set of Energy Forms;R-O-W Permit for new construction, Minimum ten(10)working days after submittal date. Required onsite,Construction Plans, Stormwater Plans w/Silt Fence installed, I 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,Stormwater 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. ..��1.�� . ■ ■ . ■ ■ . ■ 4�.�..�� ■.�.�'��0�1..��1..4�' '�„�7 •�� '...�ri..r�'�..'r'��i..i��' '...ri�'�..'��'��7 '��' '�'� '��' '...�r•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 Attorney(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(PIoUSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW