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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar�St., EXerett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> U - ill v&f I SEo (6 VA <br /> SITE ADDRESS: PROPERTY TAX# ERM <br /> 1931 Mukilteo BLVD Everett,WA 98203 00417100004703 i r C)L4 <br /> LEGAL for new construction: Short Plat/subdivision see attached Lot No. (attach copy of long legal description) <br /> OWNER Snohomish County PUD Phone/E-mail <br /> Address 21018 WA 99 City/State/Zip Edmonds,WA 98026 <br /> APPLICANT:_Owner _Owner's Agent _Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> a `3 1 <br /> CONTRACTOR Tom' t L� State Lic. City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMITColin Robinson <br /> 425-533-2665 <br /> T-Mobile Phone/E-mail colin.robinson@cascadiapm.com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $20,000 <br /> Existing Use of Building Wireless Communications Facility HEAT SOURCE: <br /> Proposed Use of Building Wireless Communications Facility Gas Electric Other <br /> Building type: Single Family _Duplex_Townhouse —Multi-Family Commercial <br /> Type of ro'ect: New Addition Remodel —Repair_T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): Modification of existing wireless communications site. <br /> On pole:remove 2 antennas,add 2 new antennas,add 2 remote radio units with cabling and remove 2 TMAs. <br /> On Ground:decommission 1 U2100 <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 /> 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 /> Refri eration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads I 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 /> 8-11-2015 til <br /> Owner/Authorized Agent Signature Date (Revised 4/2015) 1111( <br />