2605 15TH ST 2025-04-18 - Laserfiche WebLink

MINE Ira •LDING PERMIT APPLICATTN EVERETT CITY OF EVERETT PERMIT SERVICES 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)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2605 15th St. PARCEL#: 00386200600000X cm' Everett STATE WA ZIP 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable):Roof TENANT/BUSINESS NAME (if non-residential):Bakerview Apartments LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Housing Authority of Everett OWNER MAILING ADDRESS: STREET 3107 Colby Ave. C1TY Everett STATE WA ZIP 98206 OWNER PHONE:425-303-1 128 OWNER EMAIL: info@evha.org CONTRACTOR COMPANY NAME:Legacy Telecommunications WA STATE CONTRACTOR LICENSE#(REQUIRED):LEGACTL821 LL CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 42661 CONTRACTOR ADDRESS: sTREET81 02 Skansie Ave cm( GIG HARBOR STATE WA zip 98335 CONTRACTOR PHONE:(509) 660-3014 CONTRACTOR EMAIL:jOrdan.Schilling@legacytowers.com PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:830_387-6471 David Baker CONTACT EMAIL:david.baker@enertechresources.corn BUILDING INFORMATION VALUATION OF WORK: $17,775 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:Apartments PROPOSED USE OF BUILDING:Apartments 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 ❑T.I. ❑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:Demo DESCRIPTION OF WORK:Removal of all print cell site elements including antennas, microwaves, radios, mounts, cabling, hardware, equipment cabinets, junction boxes and distribution boxes. 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 Use Only 3/7/2023 PERMIT# Owneothorized Agent Signature Date (Revised 4/21/2022)