8215 BROADWAY T MOBILE ANTENNAS 2021-02-22

V ign,_ PERMIT APPLICATIO• BUILDINNMECHANICAL/ PLUMBING / SIGN / SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 8215 Broadway,Everett,WA 98203 PROPERTY TAX#: 280508-003-015-00 LEGAL for new construction Short Plat/subdivision Lot No. (attach copy of long legal description) See attached CONTACT INFORMATION OWNER NAME: Global Signal Acquisitions IV LLC TENANT NAME(If Commercial): T-Mobile OWNER MAILING ADDRESS: STREET PO Box 277455 CITY Atlanta STATE GA ZIP 30384 OWNER PHONE: "- OWNER EMAIL: CONTRACTOR NAME: .r_ C rC LA ► L( Ipl,‘ CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: !1 CONTRACTOR EMAIL: � CONTRACTOR LICENSE#(REQUIRED): G 1 1 G VV\W V9'J 2c�(1.—, CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): ��( ).- PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR OTHER(Please Specify) Agent CONTACT NAME: CONTACT PHONE: 206-336-3204 __ Sarah Baird,Crown Castle,on behalf of T-Mobile CONTACT EMAIL: sarah.bairdt astle.corn `\ BUILDING PERMIT APPLICATION i Existing Use of Building: Wireless Communications Facility Contract Price of W6rk: $ 20,000 i / Proposed Use of Building: No change Heat Source: ❑ as ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of U its: ®Comrrcial ❑Industrial Type of Project: ONew ❑Addition ®Remodel ORepair CIT.!. DSign ❑Sp nkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: T-Mobile proposes to replace(3)antennas;remove(1)RF module a d(1)TMA's;and. tall(3)RRU's and(1)hybrid cable on existing tower.T-Mobile also proposes to replace(1)cabinet;remove(3)system modules and(1)R odule a )cabinet;relocate(1)system module,(3)RF modules,and(1)COVP;and install(1)CSR and(2)sub-tracks with(5)modules within existing compound. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New — 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 - 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 _Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water I No. of Heads ACKNOWLEDGEMENT..I have reviewed this application and confirm the information contained herein is true and correct. Work done 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 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 4.� AP 8/30/2019 PER vio ^ �� - Owner ,uthorized Agent Si�*i Date (Revised 9/23/2016) (�` ��Cz