3202 20TH ST WSDOT 2021-09-09 - Laserfiche WebLink

• • PERMIT APPLICATION /#01,t1P44:7,....4,-- BUILDING /MECHANICAL/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. 3 O92OTf t vT `2,0 z, Z,0-0h PROPERTY TAX#: 00563241100100 LEGAL for new construction: Short Plat/subdivision see legal sheet A-1 dwgs Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Washington State DOT TENANT NAME(If Commercial): New Cingular Wireless PCS,LLC(AT&T). OWNER MAILING ADDRESS: STREET P.O Box 330310 CITY Seattle STATE WA ZIP 98133 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: General Dynamics Info Tech CONTRACTOR ADDRESS: STREET 19240 Des Moines Memorial Drive South Suite 300 crrY SeaTac STATE WA ZIP 98148 CONTRACTOR PHONE: 425-201-4830 CONTRACTOR EMAIL:jay.kim@gdit.com CONTRACTOR LICENSE#(REQUIRED): GENERDI927CG CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):054962 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 417 OTHER(Please Specify) Authorized Agent CONTACT NAME: CONTACT PHONE: 0: 206-523-1941 /M: 425.351.3392 Christine Contreras, on behalf of AT&T CONTACT EMAIL:ccontreras@rykaconsulting.com BUILDING PERMIT APPLICATION Existing Use of Building: Unmanned Wireless Communications Facility Contract Price of Work:$7,500 Proposed Use of Building: Unmanned Wireless Communications Facility Heat Source: ❑Gas ❑Electric ❑Other N/A 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: AT&T is proposing to replace (3) existing remote radio heads with (3) new remote radio heads. No increase in height or ground disturbance. ASSOCIATED BUILDING PERMIT#(if applicable): B1802-021 MECHANICAL PERMIT APPLICATION N/A I PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair N/A L #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 I SUPPRESSIO SYSTEM 'Number of Heads IN/AI ACKNOWLEDGEMENT:/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.lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, and/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. �Citty of Everett Official Use Only Z____,.,„___----- 3 D �� PERIVi L�c�o 025 Owner Signature D (Revised LV9//23/2016) yz___