906 SE EVERETT MALL WAY T MOBILE ANTENNA 2019-09-05

PERMIT APPLICASITG I BUILDING /MECHANICAL/ PLUMBING I SIGN/SPRINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits ... ,. (Blule'olr wick Ink=Only=Please) PRO.IECT-SITE INFORMATION, PROJECT SITE ADDRESS: 906 SE Everett Mall Way, Everett, WA 98208 PROPERTY TAX#: 28051800308500 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) ,CONTACT'INFORMATION OWNER NAME: PFLUEGER EVERETT HOLDINGS LLC TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 601 Union ST#5300 crry Seattle STATE WA zIP 98101 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: �.y.�.,J (CONTRACTOR EMAIL: ' CONTRACTOR LICENSE#(REQUIRED):NQQ:Ti �cg(1'ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED)i)Og • • PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR vi OTHER(Please Specify) Applicant CONTACT NAME: CONTACT PHONE: 206-434-7019 Max Kvern CONTACT EMAIL: max.kvern@taec.net BUILDING PERMIT APPLICATION Existing Use of Building:Rooftop Wireless Facility Contract Price of Work:$ $25,000 Proposed Use of Building: ROOftoD Wireless Facility Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: VECommercial ❑Industrial Type of Project: ❑New 171Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: T-Mobile is proposing to modify the existing wireless facilities located on the roof of the property. Please see building plans. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT"APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New Addn _Alteration Repair Type of Project: _New _Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM 'Chemical or Water I No.of Heads 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 PERMIT# MAX (Cv 'sv On behalf of T-Mobile 7/2/18 ' (1 Owner/Authorized Agent Signature Date (Revised 9/23/2016)