Fillable Ttower & Co-Location Antennas Application Form (Page 2 of 2) in pdf

Ttower & Co-Location Antennas Application Form Page 2

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TOWER & CO-LOCATION ANTENNAS

(PLEASE TYPE OR PRINT CLEARLY)

CONTRACTOR INFORMATION:

License Holder:

License #

Company Name

Phone #:

Mobile #

Fax #

Address:

E-Mail Address for Business Use:

The standard method of notification is by e-mail, when available

Preferred Pick up location: Daytona Beach

DeLand

Private Provider Review: Yes___ No___ Private Provider Inspections: Yes___ No___

_____

____

SUBCONTRACTORS: Enter name & license number for each subcontractor

Elec

Arch

Eng

Other

License #

Bonding Company Name_____________________________________________ Address_________________________________________________________

Mortgage Lender’s Name_____________________________________________Address_________________________________________________________

Arch’s/Engr’s Name_________________________________________________ Address_________________________________________________________

APPROVED BY __________________ (PERMIT OFFICER)

GATE CODE

*Land Development Approval is needed for:

New Tower

Co-Location: New Equipment Building, New &/or additional Slab (existing slab does not require Land Development approval)

** Submittal Information: (Checklist of items that must be provided)

Three (3) sets of engineer/architect plans and Specs

Three (3) site plans showing the type and height of the tower, and the location of any accessory buildings

One (1) site plan approved by Land Development, if applicable

Acknowledgement letter that engineer will certify the work at the end of the project.

Identification of the wireless communication service provider.

The owner(s) of the structure, and the land owner upon which the antennas will be located.

Lease Agreement, if applicable.

*A completed application for a building permit must be submitted with the necessary documents. If the minimum requirements (documents & plans) have not

been met, the review, processing & issuing of this permit will be delayed. All plans and appropriate documents must be in accordance with the requirements of

the current Florida Building Code(s). **This information is intended as a guideline for application submittal and may or may not be all inclusive.

July 2015