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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS:6107 Berkshire Dr.;Everett 98203 PROPERTY TAX# P RMIT# <br /> 28050600400900 I S Ot\-.01-1t <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER City of Everett Phone/E-mail <br /> Address 3002 WETMORE AVE City/State/Zip Everett,WA 98203 <br /> APPLICANT:_Owner _Owner's Agent Com <br /> Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR TBD2 Cv i r r / State Lic.# City Bus.Lic.# 0 <br /> Alvp► <br /> Address 4 � Phone/Email 0 St <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Andi Spencer on behalf of Crown <br /> T-Mobile, Crown Castle Castle/T-Mobile 206-336-2867 <br /> Phone/E-mail Andi.spencer.contractor@crowncastle.com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 45J)00 00 <br /> Existing Use of Building 131 ft Monopole HEAT SOURCE: <br /> Proposed Use of Building Existing Monopole Gas Electric Other <br /> Building type: Single Family _Duplex Townhouse _Multi-Family X Commercial <br /> Type of project: _New Addition Remodel _Repair X T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Swap (3)panels for(3) new panels; adding(3) FRLBs to the ground.FINAL CONFIGURATION of: (6)panels, <br /> (12) coax cables, (1) hybrid cable, (3) FRIG, (2) FXFB, (6) diplexers AND (1) COVP. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be comp <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That 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. <br /> 4.64'304 u °'v 6 l U elLe`r"L 07/28/2015 <br /> Owner/Authorized Agent Signature Date (Revised 4/2015) <br /> 112 <br />