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LI <br /> IERMIT APP CATI Ot <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# RMIT# �\ <br /> 8401 Holly Drive Everett,WA 98208 28051800201700 +✓ — C L% <br /> LEGAL for new construction: Short Plat/subdivision SEC 18 TWP 28 RGE 05 Lot No. (attach copy of long legal description) <br /> OWNER Snohomish County PUD Phone/E-mail 425-783-5681 <br /> Address PO Box 1107 Everett,WA 98206 City/State/Zip Everett,WA 98206 <br /> : <br /> APPLICANT:_Ownern ,,Owner's Agent Contractor Contractor's Agent Tenant(must Provide a letter of consent from theowner to d <br /> CONTRALTO .J&B' (i ( tate Lic.# �` j I S ty Bus ic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Colin Robinson for T-Mobile <br /> T-Mobile 360-561-3311 425-533-2665 <br /> Phone/E-mail colin.robinson@cascadiapm.com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $20,000 <br /> Wireless Communications Facility n/a <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Wireless Communications Facility Gas Electric Other <br /> Building type: _Single Family —Du <br /> pI _Townhouse —Multi-Family Commercial <br /> Type of project: New Addition Remodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> On Pole:remove 3 existing panel antennas,remove 3 existing TMAs,add 3 new panel antennas,add 3 new remote radio units with cabling <br /> On Ground:remove 4 existing baseband modules and add 1 new baseband module. <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 /> j <br /> Range hood Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> I Heat pump Backflow preventer inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> I Woodstove Grease trap <br /> I <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 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 a// Z m 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. r <br /> . ¢i;° f 6-- 8-3-2015 t/Z-- <br /> Owner/Authorized Agent Signature Date (Revised 4/2015) <br />