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( �� � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> _ APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � —/(/,..D� <br /> U <br /> SITE ADDRESS PARCEL TAX I.D,il PERMIT A <br /> 5828 Glenwood Ave.,Everett,WA 98203 28040100201200 D5- O�1 <br /> LEGA LOT NO. BLOCK TRACT Oq SUBDIVISION p <br /> DESC. �p 12 N/q <br /> OWNER(PfOpehy) AUDRESS CITY2IP PHONE <br /> Public Utility Dist. No t Snohomish County 2320 California St,Evereq,WA 98201 (877)753-1000 <br /> TENANi NAME Verizon Wtreless(applicant): CONTACT FOR PERMIT PHONE (425)308•8710 <br /> t5900 SE[asigate WayM/S 231 I KDC Architects and Engineers: <br /> Bellevue,WA98008 MelissaHelland E•MAIL elissa.Hellantl�kdwrchitects.com <br /> N A TBD ADD TBD I N <br /> TBD <br /> CONTR.LICENSE# TBD <br /> I <br /> USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> N/A N/A Electric N/A Gas N/A Other 560,000 <br /> WORK DE&CRIPTION <br /> Collocating on an existing Wireless Communications Utility Pole. installation of 3 panel antennas flush mounted to pole. 4 <br /> equipment cabinets and 7 future equipment cabinet. Installation ol a back•up generatoc � <br /> �', j�(�t O�" Q7Z <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM N0. TYPE OF FI%TURE OR ITEM <br /> N�A Toilet N/A qiC—air handling units <br /> _ Bathtub Forced air systems <br /> _ Lavatory(wash basin) Gas piping <br /> ' _ Shower Water heater <br /> _ Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher _ Gasrange <br /> � _ Clothes washer Clothes tlryer <br /> � _ Water heater _ Range hood <br /> _ Sink(serviceibaumop.�etc.) Exhaust fan <br /> _ Backflow preventer Heat pump <br /> � _ Urinal _ Unit heater <br /> _ Drinking Fountain Boiler <br /> _ Floor drain Relrigeration <br /> _ Greasetrap Woodstove <br /> _ Roof drains Other <br /> Other — <br /> I CITY OP EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify Ihat I have read and examined this application antl know the same to be true and correct. All provisiors of laws and <br /> � ordinaces goveming this type o(work will be complied with whether specified herein or noL The granting of a permit does not presume <br /> to give authority to violate or c3ncel the provision of any other state or local law regulating construction or the peAormance of <br /> consiruction.That I am authcrized by ihe owner ot ihis property ro pedorm ihe work lor which application is made and I comply with the <br /> State Contractors Law 1827 f,CW antl 296.200 WAC. <br /> ��i%%r���—��� 5/I4/ �R <br /> SignaNre ef Owner,Contractor/Authonzetl Agent ate <br /> �I� <br /> I <br />