2520 MADISON ST DISH WIRELESS 2025-08-08

ATC 83177-Verizon Upgrade-13661993 mai uns BUILDING PERMIT APPLICA1 IUN 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 3200 Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION: (P)425.257.8810 I(E)everetteps@everettwa.gov I (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2520 MADISON STREET PARCEL#: 28050800200100 clrY EVERETT STATE WA ZIP 98203 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: American Tower Corporation (Tower Owner) OWNER MAILING ADDRESS: STREET 10 Presidential Way CITY Woburn STATE MA ZIP 01801 OWNER PHONE: 972-999-8900 OWNER EMAIL: CONTRACTOR COMPANY NAME:GENERAL DYNAMICSff.. INFORMATION TECHNOLOGY WA STATE CONTRACTOR LICENSE#(REQUIRED): GGNC.ci-m ` CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 54962 CONTRACTOR ADDRESS: STREET 101 Station Drive 3D05 CITY Westwood, MA 02090 STATE ZIP CONTRACTOR PHONE: 318-833-4866 CONTRACTOR EMAIL: Jay.kim@gdit.com PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR X OTHER(Please Specify) Owner's Authorized Agent CONTACT NAME: CONTACT PHONE: 205-235-6784 Katie Kyle CONTACT EMAIL: kkyle@craftongroup.com BUILDING INFORMATION VALUATION OF WORK:$ 25,000 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: Wireless Cellular Communications Facility PROPOSED USE OF BUILDING: Modifications to Existing Wireless Cellular Communications Facility HEAT SOURCE: ❑Gas ❑Electric ❑Other Not Applicable BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: Commercial EAccessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ElAddition ❑Remodel ❑Repair ❑T.I. ❑Change of Use ❑Modular ❑Portable ❑Re-roof XExterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) Other: Alteration-Upgrades to Existing Cell Tower DESCRIPTION OF WORK: ATC 83177-Verizon Upgrade to existing cell tower including removing 12 Verizon panel antennas,6 Verizon RRUs,and 1 Verizon OVP,and installing 6 NHH-45C-R2B panel antennas,3 AIR6449 panel antennas,3 8843 RRUs,3 RRUs, and 1 RCMDC-6627-PF-48 OVP on tower.Ground work includes removing 1 Verizon OVP and installing 1 RCMDC-6627-PF-48 OVP.See plans for details. 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 Contractors Law 18.27 RCW and 296.200A WAC. /� City of Everett Official UseUs[Only f�l 4 Z PERMIT# 0 6 l/l� 9/15/2021 Owner/Authorized Agent Signature Date (Revised 2/8/2021) I /Z.