319 76TH ST SW T MOBILE ANTENNA 2019-09-18

PERMIT APPLICATION BUILDING . MECHANICAL / PLUMBING / SIGN / RINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 319 76th St. SW, Everett, WA 98203 PROPERTY TAX#: 003920-000-060-05 LEGAL for new construction: Short Plat/subdivision Sec attached property report Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: City of Everett TENANT NAME(If Commercial): Tower Operator-Crown Castle OWNER MAILING ADDRESS: STREET 2930 Wetmore Ave CITY Everett STATE WA ZIP 98201 OWNER PHONE: ' I �p ;OWNER EMAIL: CONTRACTOR NAME: TBD �/e W ! �F't✓ tre SS CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR E OTHER(Please Specify) Authorized Agent CONTACT NAME: CONTACT PHONE: 206-336-3204 Sarah Baird, Crown Castle, on behalf of T-Mobile CONTACT EMAIL: sarah.baird@crowncastle.com BUILDING PERMIT APPLICATION Existing Use of Building: Wireless Facility Contract Price of Work: $ 5,000 Proposed Use of Building: N/A Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ®Commercial ❑Industrial Type of Project: ❑New ®Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: T-Mobile proposes to install(1)APU 48VDC Generator 7.5kw and(1)ASME 120 gallon LP tank w/fill valve with integral manual shutoff valve. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New X Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal I Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink& Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups 1 Other:Propane Tank Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER I SUPPRESSION SYSTEM Chemical or Water No. of Heads ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work dune pursuant to this permit must comply with current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official before being authorized under any circumstance. I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# i 11/30/2017 Owner/Authorized Ag Signature Date (Revised 9/23/2016)