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0 0 <br /> 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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: errill Creek PkwyEverett WA PR <br /> -U683-003-00 Ax P MI J�µ . <br /> 8 'Y9 r4 t C r l� <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Polo Properties Phone/E-mail <br /> Address 3020 Issaquah Pine LakeRD SE #55 City/State/Zip Sammarrlish, WA 98075 <br /> APPLICANT:_Owner --X Owner's Agent _Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR TBD L& I Lic.# COE Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME SlUg 2.,5 SE54XC0�9 CONTACT FOR PERMIT Renee Thompson obo of Crown Castle <br /> applicant is Crown Castle�JJA olio ot�Sprtnt CS <br /> Phone/E-mail425-202-0194 Renee.Thompson.contractor@ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 20,000crowncast e.com <br /> Existing Use of Building Existing cell phone tower HEAT SOURCE: <br /> prin proposes to install new an ennas, RRH' <br /> Proposed Use of Building er heiaht as_ Electric_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse —Multi-Family X CommeUl ial <br /> Type of project: New Addition Remodel Repair_X T.I._Sign_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORKadditional space provided on the back): <br /> Sprint proposes to instal (3) new antennas, (3) RRH's and (6) Junction cyclinders. No increase to tower <br /> height or ground space. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair N/A Type of Project: _New_Addn _Alteration_Repair N/A <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C–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 <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 complied <br /> witiNhether 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 /> Th�t- thorized 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 /> otikner/Au rized Agent Signature Date (Revised 6/2012) <br />