1832 WALNUT ST T MOBILE ANTENNA 2019-11-26

0447.7- • PERMIT APPLICATIOP BUILDING / MECHANICAL/ PLUMBING / SIGN / SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps©everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 1832 Walnut Street, Everett, WA 98201 PROPERTY TAX#: 00556340601701 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Snohomish PUD #1 TENANT NAME(If Commercial):T-Mobile West LLC OWNER MAILING ADDRESS: STREET PO Box 1107 cTY Everett STATE WA ZIP 98206 OWNER PHONE: ,7----/P1 \ OWNER EMAIL: CONTRACTOR NAME •--,3- L t-,2_o Si. CONTRACTOR ADDRESS: STREET \ CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: 1 CONTRACTOR LICENSE#(REQUIRED ,,_.A.Jl(,J t 5' CITY OF EVERETT BUSINESS LICENSE#(REQU -ED). r PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) Vendor for T-Mobile ., CONTACT NAME: Charles Li CONTACT PHONE: 425-765-6220 Centerline Solutions CONTACT EMAIL: cli@centerlinesotutiOns.com BUILDING PERMIT APPLICATION Existing Use of Building: Utility Pole Contract Price of Work'$ $20,000.00 Proposed Use of Building: Utility Pole Heat Source: OGas ❑Electric ❑S7ther Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ®Commercial ❑Industrial Type of Project: ❑New ®Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler '❑Demolition OChange of Use DESCRIPTION OF WORK: T-Mobile is proposing a minor modification to an existing wireless communication facility on a SnoPUD utility pole.The scope of work is to remove(5) radios and add (6) new radios. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems _ Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: ,Exhaust Fan 7 Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/ SUPPRESSION SYSTEM 'Chemical or Water ' No.of Heads ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with current federal.state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official before being authorized under any circumstance.I am the owner.or 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. City of Everett Official Use Only ( ///yyy + PERMIT#Sn/\tl�`\) /� -y�/ Owner/Authorized Agerlt Signature Date 5 — 0'4 C 1 (Revised 9/23/2016) (.1E-,)