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• • <br /> 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 /> 9830 Evergreen Way 28041300305300 0)140(9'0 )7 <br /> LEGAL for new construction: Short Plat/subdivision (See T-1 on plans set) Lot No. (attach copy of long legal description) <br /> OWNER T-Mobile,Snopud (contact: Becky Todd, Lexcom) Phone/E-mail 206-310-1793/becky.todd@Iexcomcorp.com <br /> Address do Lexcom Development, 617 8th Ave S. city/State/zip Seattle,WA 98104 <br /> APPLICANT:_Owner X Owner's Agent _Contractor _Contractor's Agent _Tenant(must V provideyvia cletter of consent from the owner to do work in the space) <br /> CONTRACTOR M CD yri State Lic.# j%AYCOrv► ' A O EZ.Clrty us.Lic.# <br /> Address RadSWe `( GA Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> SE01693B Casino Corner(T-Mobile)wireless facility Becky Todd, Lexcom Development <br /> Phone/E-mail 206-310-1793/becky.todd@lexcomcorp.com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building unstaffed wireless facility on utility pole HEAT SOURCE: <br /> Proposed Use of Building no change Gas_ Electric Other_ <br /> Building type: _Single Family Duplex_Townhouse _Multi-Family X Commercial <br /> Type of project: New Addition Remodel Repair X T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> At existing wireless facility on Snopud utility pole, replace (3)antennas with new models; replace (3)TMA with new <br /> models. On ground within fenced lease area, remove existing diplexers, add H-frame and post, install (3) FRLB radio <br /> units and (3)diplexers to proposed H-frame. <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 /> NC—air handling units Toilet <br /> Forced air systems 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(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <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 am 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. <br /> Ow r/ uthor d Ag Signature Date (Revised 4/2015) <br /> ` Z <br />