5828 GLENWOOD AVE VERIZON ANTENNA 2022-10-14

47-1- PERMIT APPLICATION 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: 5828 Glenwood Avenue PROPERTY TAX#: 28040100201200 LEGAL for new construction: Short Plat/subdivision legal on sheet Al site plan Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Public Utility Dist 1 Sno Co (SnoPud) TENANT NAME (If Commercial): Verizon Wireless OWNER MAILING ADDRESS: STREET PO Box 1107 CITY Everett STATE WA ZIP 98206 OWNER PHONE: 425-783-1000 OWNER EMAIL: MMNave@SNOPUD.com CONTRACTOR NAME: Steelhead Communications Inc CONTRACTOR ADDRESS: STREET 28120 ST RT 410 E STE A3 CITY Buckley STATE WA ZIP 98321 CONTRACTOR PHONE: 360-829-1330 CONTRACTOR EMAIL: Shane@steelheadcom.com CONTRACTOR LICENSE#(REQUIRED): STEELCI972BS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):52133 PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR 0 OTHER(Please Specify) Authorized Agent CONTACT NAME: CONTACT PHONE: 0: 206-523-1941 / M: 206-949-3321 Chris DeVoist on behalf of Verizon Wireless CONTACT EMAIL: cdevoist@rykaconsulting.com BUILDING PERMIT APPLICATION Existing Use of Building: Unmanned Wireless Communications Facility Contract Price of Work: $25,000 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:_ ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ORemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: VERIZON PROPOSES TO REMOVE (6) ANTENNAS, 2 MOUNTS, AND ANCILLARY EQUIPMENT FROM AN EXISTING WOOD UTILITY POLE AND INSTALL (6) NEW ANTENNAS, (6) RRHs, NEW ANTENNA MOUNT, AND (1) OVP WITH ASSOCIATED CABLING ONTO A REPLACEMENT STEEL POLE (POLE REPLACEMENT APPROVED UNDER PERMIT B1905-005). ASSOCIATED BUILDING PERMIT#(if applicable): B1905-005 MECHANICAL PERMIT APPLICATION N/A PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair N/A _ Fixtures List of Fixtures Fixtures List of Fixtures #of List of Fixtures #of List of 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 /SUPPRESSIO�TEM Number of Heads N/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 Co aw 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 9/11 /20 � T1\#<:\v(.0 _Q 1 4 wner/ orized Agent Signa Date (Revised 9/23/2016)