1602 HEWITT AVE VERIZON WIRELESS ANTENNAS 2024-10-24

BIDING PERMIT APPLICATW N CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASHINGTON then drop off completed application plus all required submittal documents to 320Q Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION: (P)425-257-8810 i(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1602 Hewitt Ave PARCEL#: 00644968300300/00644968303200 '< , CITY Everett V. , STATE WA, ZIP 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Verizon - Deadman Slough, LEGAL DESCRIPTION for new construction: Short Plat/subdivision: SE1/4 SEC19 T29N R5E Lot No.: (attach copy of long legal description) CONTACT INFORMATION. OWNER NAME:1602 Hewitt Ave, LLC OWNER MAILING ADDRESS: STREET PO Box 5267 CITY Everett STATE WA ZIP 98206 OWNER PHONE:. OWNER EMAIL: CONTRACTOR COMPANY NAMENOTetr0 eu.stre- X0(1,117 cv-5 C—C.- C WA STATE CONTRACTOR LICENSE#(REQUIRED). d7labsif CITY6-666/OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET Lkt C 3! 5 I-) CITY I,13 S. STATE ZIP 5;2 ti© CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Representative CONTACT NAME: CONTACT PHONE:206-604-5538 Mike Unger CONTACT EMAIL:mike.unger@acomconsultinginc.com BUILDING INFORMATION VALUATION OF WORK:$20,000 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BuiLDING:Communication site PROPOSED USE OF BUILDING:Communication site HEAT SOURCE: ❑Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑✓Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑✓Addition ❑Remodel ❑Repair ETA. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK:Verizon will be installing (2) 15" microwave antennas on their equipment shelter. 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 properly 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 5/31/23 P L O'O�(o Owner uthon d Agen Signature Date (Revised 4/21/2022)