7401 OLYMPIC DR T-MOBILE ANTENNA 2022-02-25

0 PERMIT APPLICATION* EVERETT WASHINGTON BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 7410 Olympic Drive, Everett, WA 98203 PROPERTY TAX #: 00394000006600 LEGAL for new construction: Short Plat/subdivision See plans Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: City of Everett TENANT BUSINESS NAME (Commercial): OWNER MAILING ADDRESS: STREET 2930 Wetmore AVe cITY Everett STATE WA zip 98201 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: To be determined at issuance CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE #(REQUIRED): CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR 0 OTHER (Please Specify) Agent CONTACT NAME: Max Kvern, on behalf of T-Mobile CONTACT PHONE: 206-434-7019 CONTACT EMAIL: max.kvern@taec.net BUILDING INFORMATION Existing Use of Building: Unmanned Wireless Telecommunications Facility Contract Price of Work: $ 25,000 Proposed Use of Buildin : Unmanned Wireless Telecommunications Facility Heat Source: ❑Gas []Electric ❑Other N/A BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New OVAddition ❑Remodel ❑Repair LIT. 1. ❑Sign ❑Sprinkler ❑Demolition ❑Chan e of Use DESCRIPTION OF WORK: T-Mobile proposes to modify an existing water tank wireless telecommunications facility. Please see the plans for the full scope of work. ASSOCIATED BUILDING PERMIT # (if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Count List of Fixtures Fixture Count List of Fixtures Fixture Count List of Fixtures Fixture Count List of Fixtures A/C —Air Handling Units Gas Piping Backflow Preventer (Inside Bldg) Shower, Tub, or Combo Boiler Gas Range Clothes Washer Sink -Commercial (3-comp,prep, floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink -Residential (kitchen, bath, bar) Duct System (Remodel) Refrigeration Drinking Fountain Sink -Utility, laundry, mop Exhaust Fans (Residential) Commercial Ventilatior (Not Heat/AC system) Floor Drain Toilet Exhaust Hood (Type 1) Hose Bibb Urinal Exhaust Hood (Type 11) Water Heater Interceptor -Grease Waste/Water Piping Repair Exhaust Hood (Residential) Wood Stove Interceptor-Sand/Oil Water Service (behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log I Roof Drains Water Heater SPRINKLER / SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other Water Suppression System No. of Heads Chemical Suppression System I I No. of Heads ACKNOWLEDGEMENT. 1 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. 1 am the owner, or 1 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 71t 10/30/20 Owner/Authorized Agent Signature Date (Revised 1011012018)