906 SE EVERETT MALL WAY T MOBILE ANTENNA 2021-09-22

• 111/ PERMIT APPLICATION f ✓-- BUILDING/MECHANICAL/PLUMBING/SIGN /SPRINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 l 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:906 SE Everett Mall Way PROPERTY TAX#: 28051800308500 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: Pflueger-Everett Holding, LLC TENANT NAME(If Commercial): T-Mobile OWNER MAILING ADDRESS: STREET 601 Union Street#5300 CITY Seattle STATE WA ZIP 98101 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: TBD - OUT TO BID CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 4E1 OTHER(Please Specify)Authorized Agent CONTACT NAME: CONTACT PHONE: 0: 206-523-1941 /M: 425.351.3392 Christine Contreras, on behalf of T-Mobile CONTACT EMAIL:ccontreras@rykaconsulting.com BUILDING PERMIT APPLICATION Existing Use of Building: Unmanned Wireless Communications Facility Contract Price of Work:$20,000 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: 46Commercial ❑Industrial Type of Project: ❑New ❑Addition I,Z1Remodel ❑Repair CIT.!. ❑Sign ❑Sprinkler ODemolition ❑Change of Use SCRIPTION OF WORK: T-Mobile is proposing to replace the existing sleepers,add(3)panel antennas to their existing rooftop wireless facility.Additionally,T-Mobile will be removing and replacing ancillary equipment and replacing equipment cabinets inside of their existing lease area. No increase in height or projection and no ground disturbance is proposed. No increase in the number of equipment cabinets. r ASSOCIATED BUILDING PERMIT#(if applicable): B1807-007 MECHANICAL PERMIT APPLICATION N/A PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair N/A #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures NC—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 !Number of Heads IN/A 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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. _ City of Everett Official Use Only j) 3/4/21 PEST#2103, cy4 1.4...._ Owner uthorized A e >Signature Date (Revised 9/23/2016) i/