709 80TH ST SW VERIZON WIRELESS 2023-08-08

• PERMIT APPLICATION • BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER/ DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (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:709 80th Street SW PROPERTY TAX#:00412300000700 LEGAL for new construction: Short Plat/subdivision See Drawings Lot No._ (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: WILL JEANNE TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 9225 60TH AVE W CITY MUKILTEO STATE WA ZIP 98275 OWNER PHONE: 509.998.9015 OWNER EMAIL:araymond@infinigy.com CONTRACTOR NAME:TBD CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR D OTHER(Please Specify) Applicant CONTACT NAME: CONTACT PHONE:509.998.9015 Angela Raymond CONTACT EMAIL:araymond@infinigy.com BUILDING INFORMATION Existing Use of Building:Unmanned Wireless Communication Facility Contract Price of Work:$20,000 Proposed Use of Building:Unmanned Wireless Communication Facility Heat Source: ❑Gas ❑Electric DOther None BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure Type of Project: New ❑Addition ✓❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Verizon is proposing to modify an existing wireless comminication facility. No ground disturbance is proposed.. The scope of work is REMOVE 3 ANTENNAS, 3 ANTENNA FRAMES, 6 RRUs. Install 6 ANTENNAS, 3 ANTENNA frames, 3 RRUS, 1 OVP, 1 HYBRID CABLE. GROUND WORK: REMOVE (6) DIPLEXERs, INSTALL (1) OVP. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of.Fixtures .IC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans.(Residential) Commercial Ventilatior Floor Drain Toilet Exhaust Hood(Type.I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Resident. Wood Stove _Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: _Medical Gas Water Valves or Fixtures Gas Fireplace/InserULog Roof Drains Water Heater.__ SPRINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other Water Suppression System No.of Heads Chemical Suppression System No.of Heads ACKNOWLED*PEMENT: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 PEI Angela Raymond Date:20211..08.17Y095109-0 oaRaymond 8/17/2021 d f I`(//Owner/Authorized Agent Signature Date (Revised 10/00/2 -'}I