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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 ADDRESS6107 Berkshire Drive Everett, WA98203 <br />PROPERTY TAX# 28050600400900 <br />P7IT <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER Crown Castle International <br />Phone/E-mail 206-336-2870 <br />1505 Westlake Ave North, Suite 800 <br />Address <br />Seattle, e, <br />City/State/Zip <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 General Dynamics <br />state Lic. # GIi.NI:RDI927CG City Bus. Lic. <br />Address 296 SW 43rd Street, Building 4, Renton, WA. 98057 <br />425-201-3735 <br />Phone/Email <br />TENANT BUSINESS NAME <br />AT&T WA6808 Everett Golf and Country Club <br />CONTACT FOR PERMIT <br />Madeline Chaney, Camp+ Associates, 425-346-0128 <br />Phone/E-mail- madeline.chaney@campassoc.com <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Buildi Cell Tower HEAT SOURCE: <br />Proposed Use of Building_No Change Ga Electric Other Building type: <br />Single Family Duplex _Townhouse Multi -Family C)CX ommercial <br />Type of project: New Addition Remodel RepairXXT.I. _Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />Replace (3) Existing Panel antennas with (3) new panel antennas <br />Add (3) RRH Units on existing 127'-0" monopole <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New <br />Show <br />_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 <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 eciled 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 />I am aut iz 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 />61 obo General Dynamics 4/28/16 <br />j04er t r' Agent Signature Date (Revised 912014) �/Z <br />