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PERMIT APPLICATION <br /> BUILDINGIMECFIANICALIPLUMBINGlSIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, W A 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.or <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TU 4 PM 3 �—��`—'�Z <br /> PNOPEN7VTa%N P MITt <br /> $Iz,��/aDQ�S3:aVe 004 3 91-62 5-001-00 Q '�� <br /> LEGAL for new construction: Short PlaUsubtlivision Lot No._ (attach copy oi long legal descnption) <br /> OWNERSkotdal Mutual, LLC PhonelE-mail <br /> Atltlress <br /> 2707 Colby Ave Ci1ylSlzte/Zip Everett, WA 98021 <br /> CONTRACTOR TB� - provided ��a iscuance L&1 Lic.# <br /> Address T P�oneiEmail <br /> TENANT BUSINESS NAME CBeN kyC�o�dt P�R�JIITfor ATST <br /> AT&T Ffobility <br /> PhonelE-mail 206-310-1793, btodd�ptswa.com <br /> BUILDINGPERMITAPPLICATION CONTRACTPRICEOFWORK <br /> ExislingUsoofBuilding commercial offic� space, telecom facility HEATSOURCE: <br /> Proposed Uso of Building same Gas_ Electnc_ Otner_ <br /> Building type: _Single Famiiy _Duplex Townhouse _Multi-Family x Commercial <br /> Type of project: New _Addition _Remodel _Repair " T.I.__Sign_Sprinkler_Demolition_Changi� of Use <br /> Descripliono(Work(aadrtionalspacapmvidedonfhoDackJ: upgrade existing zooftop wireless site by adding three new <br /> antennas, cix remo[e radio head (RRH) units, three surge protection boxes, junc[ion box, and <br /> '�backpacY." equipment cabinet on cmall utility frame. <br /> Have you started working wilhout a permit9 _YES x NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typa of ProJact: _Now_Addn _Alteratlon_Ropalr Type ot ProJect: _New_Addn _Alleratlon_Repalr <br /> Show Number(N)o/flrfures Show Namber/NJ o(flxtures <br /> AIC—airhandlin units Toilet <br /> Forced air s stems Balhtub <br /> Gas pipin Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&dis sal <br /> Gas ran e Dishwasher <br /> Clothes d er Ciothes washer <br /> Ran e hood Wa�er heater <br /> Ezhaust fan Sink(servicefbar/mop/etc.) <br /> Heal ump BackOow preventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Fioordrain <br /> Woodslove Grease lrap <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER ! SUPPRESSION SYSTEM otner: <br /> Number ot Heads Olher: <br /> I hereby ce�ify ihal�have read and ezamineE lhis application and know the same lo bo vue anC wrtucL All provisions al laws and orAinances goveming <br /> this type ol wo�k will bo complied�Nth whether specifietl heiein or noL Tho granting ol a partnit does not presume lo g�va authonty to violale or cancel <br /> tho provision of any olher stata or local law regulaling construclion or Ue peAormance ol consiruction.That I am aulhonzed Oy Ihe owner ol Ihis property <br /> ro peAorm lhe work for which appiiwtion is made and I comply wilh Iha Stale ConL actors Law 18.27 RCW and 29fi.200 WAC <br /> y�../ti, � ����II <br /> OwnerlAulhor d nl5lgnaturn Date (ftevised2201f) <br /> I ! <br /> i1 <br /> ! � <br />