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i• SE01511A Broadway Everett SnoPUD <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />SITE ADDRESS: PROPERTY TAX # P pi <br /># <br />2320 California St Everett, WA 98201 00437866000000 �j I I"n i ah�Z, <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER Public Utility District #1 of Snohomish County Phone/E-mail <br />Address <br />PO Box 1107 City/State/Zip Everett, WA 98206 <br />APPLICANT: Owner Owner's Agent Contractor Contractor's Agent Tenant (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR D V State Lic. # City Bus. Lic. # 115 <br />Address ) G floiL Phone/Email <br />TENANT BUSINESS NAME �4 1 ,; �� l �ILt7I b j�� CONTACT FOR PERMIT Colin Robinson or -Mobile <br />I lL l� 425-533-2665 <br />T-Mobile crobinson@centerlinesolutions.com <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $20,000 <br />Existing Use of Building Office / Wireless Communications Facility HEAT SOURCE: <br />Proposed Use of Building Office / Wireless Communications Facility Gas Electric Other <br />Building type: Single Family Duplex _Townhouse Multi -Family Commercial <br />Tvoe of oroiect: New Addition Remodel Repair T.I. Sian Sprinkler Demolition Chance of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : Modify existing wireless communications rooftop facility. On Roof: remove 3 <br />panel antennas, add 3 new panel antennas, add 3 remote radio units with cabling and add 1 baseband module. <br />MECHANICAL PERMIT APPLICATION I I PLUMBING PERMIT APPLICATION <br />Type of Project: <br />Show <br />New _Addn _Alteration _Repair <br />Number (#) of fixtures <br />Type of Project: <br />Show <br />_New _Addn _Alteration _Repair <br />Number (#) of fixtures <br />A/C — air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory wash basin <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink service/bar/mop/etc. <br />Heat pump <br />Backflow preventer inside bld <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER <br />/ SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be comp <br />with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That 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. <br />17, 1-19-2016 Owner/Authorized Agent Signature Date (Revised 412015) ` `[L <br />