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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: PROPERTY TAX # PERMIT # <br />1321 Colby Ave, Everett, WA 98201 00438524600000 j;� � �,,F;� ��(J�C� <br />LEGAL for new construction: Short Plat/subdivision'R�� BLK246D-OOOBLK S246oc No.1-32 (attach copy of long legal description) <br />OWNER Providence Medical Center contact Peter Smeltz IPnoneiE-ma�i 425-261-3746 <br />dress 1321 COIbV Ave <br />City/State/Zip Everett WA 98201 <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor X Contractor's Agent _ Tenant �m�sc p�o��de a ie�ce� or �o�se�,i r�om �r,e o�,e� �o ao wo�k ��, me sPa�e� <br />CONTRACTOR General Dvnamics State �ic. #GENERD1927CG eXP2�7�C8v Bus. Lic. # <br />dre5s2g6 SW 43rd Street, Buildin 4, Renton WA 98057 Phone/Emai� 425-445-6777 <br />:NANT BUSINESS NAME CONTACT FOR PERMIT <br />AT&T Mobility WA6299 Port Gardner <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION �CONTRACT PRICE OF WORK $23,000 <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building NO ChBnqe Gas Electric Other <br />Building type: _ Singie Family _ Duplex _Townhouse _ Multi-Family X Commercial <br />Type of project: New Addition Remodel Repair _ T.I. Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />Add (3) RRH Units, Replace (3) antenna and RF canisters with larger RF Canisters, Remove (6) TMAs. Add (3) 15AMP <br />Breakers and DC6 Raycap to the ground equipment. <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C – air handling units <br />—� Forced air s stems <br />Gas piping <br />� Water heater <br />Gas fire lace <br />Gas range <br />Clothes dryer <br />� Ran e hood <br />Exhaustfan <br />j Heat pump <br />I Unit heater <br />Refrigeration <br />Woodstove <br />Ductina <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />� Bathtub <br />Lavatorv (wash basinl <br />Shower <br />Kitchen sink & disp� <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read a examine �s application and know lhe same to be true and correcL All provisions of laws and ordinances governing this type of work will be comp <br />with whether sp cified herein or n t. The an � g of a permit does not presume to give authorily to violate or cancel the provision of any other state or local law regula6ng construction <br />That t rized by ihe.ow of th� pro erty to perform the work for which application is made and I comply wi�h the State Contractors Law 18.27 RCW and 296.200A WAC. <br />2/9/2016 ///''' <br />Owner uthorize Ag t' at Date --� (Revised 9/2014) C/ <br />� b b ��Q.+�W�.�. ✓� h�,r^� G 5 ��- <br />�_J <br />