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IERMIT APPLICATIO <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:1118 80TH ST SW, Everett, WA 98203 PROPERTY TAX# 00392200001700 P MIT# <br /> LEGAL for new construction: Short Plat/subdivision see attached Lot No. (attach copy of long legal description) <br /> OWNER Pepsi Bottling Group LLC Phone/E-mail <br /> Address 1 Pepsi Way, Somers NY 10589 City/State/Zip <br /> APPLICANT:_Owner Owner's Agent Contractor X Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR MasTec Network Solutions state Lic.# City Bus. Lic.# 054443 <br /> Attn: Roseann Cropanse-or- on venson R.C.:(312)259-2396/Roseann.Cropanese@mastec.com <br /> Address 1203 114th Ave SE Bellevue WA 98004 1 Phone/Email R.E.: (253)246-4348/Ron.Evenson@mastec.com <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Gibran Hashmi,Glotel,Inc. <br /> New Cingular Wireless PCS, LLC 15375 SE 30th Place,Suite 160,Bellevue,WA 98007 <br /> doing business as AT&T Phone/E-mail (206)372-1850/ghashmi@glotelinc.com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $50,000.00 <br /> Existing Use of Building Unstaffed Wireless Communication Facility HEAT SOURCE: <br /> Proposed Use of Building Unstaffed Wireless Communication Facility GasNA Electric NA Other NA <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family X Commercial <br /> Type ofproject: New Addition Remodel Repair X T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): AT&T SN05 PAINE FIELD: Proposed modification of an.ex.unstaffed <br /> telecommunications facility by relocating(1)ex.panel antenna,replacing(2)panel antennas with(2)new panel antennas. Adding(1)new <br /> panel antenna,(6)RRH Units,(1)distribution unit to an ex.platform and proposed LTE equipment mounted on an existing FIF rack with an <br /> ex.equipment shelter. No height increase proposed. No ground disturbance proposed. No expansion of ex.compound proposed. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair NA Type of Project: _New_Addn _Alteration_Repair NA <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced airs stems 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 NA Other: <br /> I hereby certify that I have read d 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 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 a ho zed by the o ner 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 /> Gibran Hashmi, �Z <br /> 10/2/2015 Land use Planner, Glotel, Inc. <br /> Owner/Aut orized Agent Signature Date (Revised 4/2015) \� <br />