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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# I P MIT#�\ <br /> 1118 80th St.SW 100392200001700 U--oZ�) <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Crown Castle International Phone/E-mail <br /> Address 1505 Westlake Ave N Ste 800 City/State/zip Seattle WA 98109 <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 /> CONTRACTOR General Dynamics Info Tech State Lic.# GENERDI927CG City Bus. Lic.# <br /> Address 296 SW 43rd St.Bldg 4,Renton WA 98057 Phone/EmailNick Thies, 425-201-3735 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> AT&T Mobility SN05 Madeline Chaney, Camp + Assoc 425-346-0128 <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ?1,SO Q <br /> Existing Use of Building unmanned wireless facility HEAT SOURCE: <br /> Proposed Use of Building no_change I Gas Electric other <br /> Building type: _Single Family Duplex_Townhouse Multi-Family x Commercial <br /> Type ofproject: New Addition Remodel Repair T.I. Sin_Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Add 3 remote radio heads (RRHs) on pipe mounts near antennas on existing self support tower <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 i 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 <br /> Unit heater Urinal <br /> Boiler <br /> Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> DuctingRoof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM i 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 h in 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 authored b th o e 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 /> I GS <br /> Owner/Authorized Agent St:t a Date (Revised 9/2014) <br /> �r <br /> IZ <br />