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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 />�-4-ZZ� <br />ADDRESS�Ft7S'jyth 5treet, �verett, <br />TAX# 005760032000011 I P�iR_M��# <br />DLri UJG 1J11, t5L1� JG <br />1L for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />ER Crown Castle International (206) 336-7382 <br />PhonelE-mail <br />i5 1505 Westlake Ave North, Suite 800 City/State/Zip Seattle, WA. 98109 <br />.ICANT: _ Owner _ Owner's Agent _ Contractor XXContractor's Agent T8�8�t (must provide a letter of consent from the owner to do work in the space) <br />fRACTOR ��eneral Dynamics state �ic. # G�NERDI927CG City Bus. Lic. # i-'L�y� � <br />' ✓ <br />r treet, ui ing , enton, . 425-445-6777 <br />>s Phone/Email <br />�NT BUSINESS NAME CONT�, T FO PERMIT <br />AT&T SN30 Pinehurst Made�ine C�aney, Camp+ Associates, 425-750-6392 <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK `�i�+ L�(.'%� <br />Existing Use of Building CEII ToWer HEAT SOURCE: <br />Proposed Use of Building No Change Gas_ Eiectric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � 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): ReplaCe �3� eXlStlrig ArileririaS wlt�l �3� new Antennas, <br />Add (3) RRH Unils, (1) new squid, Add (3) AMP <br />Breakers. <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handiing units <br />� Forced air systems <br />� Gas pi in <br />Water heater <br />Gas fireplace <br />I Gas range <br />j Clothes dryer <br />I Ran e hood <br />Exhaust fan <br />Heat pump <br />Boiler <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fiutures <br />Toilet <br />Bathtub <br />� Lavatory (wash basin) <br />� Shower <br />Kitchen sink & disposal <br />I Dishwasher <br />Water heater <br />Sink (service/bar/ <br />Backflow preventE <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 and examined [his application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be compl <br />with whether spe.�ifed herein or noL Th�granting of -pgrmit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I a th �ed by the owner of t is Prope o perTorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />i <br />� I � <br />pwn �ut ized Age t Si atu Date (Revised 9/2014) i v <br />