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a�s-�eo-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Departme�t <br /> Date Racelved 3 '� Phon�CoMaet for Permlttin <br /> TT-TTTT <br /> owners Name Verizon Wireless owner Phona Number <br /> Owno�"s Addross 14055 Riveredge Drive,Suite 600,Tampa,FL 332637 pN,nsr phonQ Numbsr <br /> Fee Slmple Titlehdder Name C�OWh Ca5tl2 p��p�e Number �—� <br /> Fes Simpb Titleholdsr Addross 017 Washington Rd.,McMurray,PA 15317-2520 <br /> ,we n�ortESS 38522 A Avenue,Zephyrhills,FL 33542 � <br /> LOT� <br /> sueonns�or, � PARCEL ID� 1a-26-Zi-ooio-oi�oo-o060 <br /> (OBTAINED FROM PROPEItTY TAl(NOTICE) <br /> WORK PROPOSED B NEW CoNSTA 8 ADO/ALT Q SIGN � Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONBTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK �nstall antennas&lines to existing telcom tower �/ — /i1 —�� <br /> BUILDING SI2E � "�A SQ FOOTAGE N�A HEIGHT N/A <br /> STRUCTION <br /> QELECTRICAL S AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ �// � <br /> � -��� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLO00 20NE AREA QYES NO <br /> BUILDER �`�COMPANY �CROMPTON ELECTRIC,INC � <br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y!N <br /> address 1799 7TH AV ,LAKE WORTH FL 33461 �icense# CGC62911 � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE cURREn Y/N <br /> Address License# �� <br /> PLUMBER COMPANY � <br /> SIGNATURE REGISTERED Y! N �E cuwtE� Y 1 N <br /> Addresc License# �— <br /> AIECHANIGLL COMPANY � <br /> SI(iNATURE REGISTERED Y! N �e cuwtEn Y!N <br /> Addreas License# �� <br /> ER �. /� COMPANY �i �At d' <br /> SI(iNATURE �i��'� r�asr�D Y N r�E cur�n Y!N <br /> Address License# � <br /> IIIIIIIIIIIIt1111111111 / 111111111111111111111111111111111111i111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)waking days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciliNes 8 1 dumpster;Site Work Pertnit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Lite Safery Page;(1)set of Energy Fortns.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster Site Work Pertnit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> 'J ' i.l � i i�i Y i ' �i 1 1 i 1 1 1 i • 1 � • ' 1 f i •J • 1 i • 1 i • • 1 • • 1 • <br /> Direetlons:• <br /> Fill out application completely. <br /> Owner 8 ConVactor sign back of application,notarized <br /> If over 52500,a Hotice of Commencsment Is required. (AIC upgndes over i75�) <br /> '" Agent(tw the contractor)or Power ot Attomey(for the owner)would be someone witti noTarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application ONy) <br /> Reroofs If shingies Sewers Service Upgrades NC Fences(Wot/Surveylfootage) <br /> Driveways-Not over Counter i(on puWic roadways..needs ROW <br />