Laserfiche WebLink
• <br /> IIP <br /> PERMIT APPLICATION <br /> BUILDING/ MECHANICAL/PLUMBING/SIGN /SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> /1"--a <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:5828 Glenwood Avenue PROPERTY TAX#: 28040100201200 <br /> LEGAL for new construction: Short Plat/subdivision legal on sheet Al site plan Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Public Utility Dist 1 Sno Co (SnoPud) TENANT NAME(If Commercial): Verizon Wireless <br /> OWNER MAILING ADDRESS: STREET PO Box 1107 <br /> cirr Everett STATE WA zip 98206 <br /> OWNER PHONE: 425-783-1000 OWNER EMAIL: MMNave@SNOPUD.com <br /> CONTRACTOR NAME: General Dynamics Info Tech <br /> CONTRACTOR ADDRESS: STREET 19240 Des Moines Memorial Drive South Suite 300 <br /> CITY SeaTac STATE WA ZIP 98148 <br /> CONTRACTOR PHONE: 425-201-4830 CONTRACTOR EMAIL: Jay.kim©gdit.com <br /> CONTRACTOR LICENSE#(REQUIRED): GENERDI927CG CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):054962 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR Zl OTHER(Please Specify) Authorized Agent <br /> CONTACT NAME: CONTACT PHONE: 0: 206-523-1941 /M: 206-949-3321 <br /> Chris DeVoist on behalf of Verizon Wireless CONTACT EMAIL:cdevoist©rykaconsulting.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Unmanned Wireless Communications Facility Contract Price of Work:$25,000 <br /> Proposed Use of Building:Unmanned Wireless Communications Facility Heat Source: ❑Gas ❑Electric ❑Other N/A <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ['Addition 1/7Remodel ['Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> VERIZON PROPOSES TO REMOVE(6)ANTENNAS, 2 MOUNTS, AND ANCILLARY EQUIPMENT FROM AN EXISTING WOOD <br /> UTILITY POLE AND INSTALL(6)NEW ANTENNAS, (6) RRHs, NEW ANTENNA MOUNT, AND(1)OVP WITH ASSOCIATED <br /> CABLING ONTO A REPLACEMENT STEEL POLE(POLE REPLACEMENT APPROVED UNDER PERMIT B1905-005). <br /> ASSOCIATED BUILDING PERMIT#(if applicable): B1905-005 <br /> MECHANICAL PERMIT APPLICATION IN/A I PLUMBING PERMIT APPLICATION <br /> Type of Project: New_ Addn _Alteration _Rep r Type of Project: New _Addn _Alteration _Repair IN/A <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSIOPJ-SYSTEM <br /> (Number of Heads N/A I <br /> 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 <br /> 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 <br /> Building Official before being authorized under any circumstance.I am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 1* I P �.oco - <br /> Owned orized Agent Sign Date (Revised 9/23/2016) <br /> Y2 <br />