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4rifir PERMIT APPLICATM <br /> BUILDING/ MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or-Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2420 39th St PROPERTY TAX#: 00576003200011 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Jack Sheeler TENANT NAME(If Commercial) Sprint <br /> OWNER MAILING ADDRESS: STREEr8919 Eastview Ave. <br /> cry Everett STATE WA zip 98208 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NA E: TBD 1))I J pAek/1/` Tele-co/1(1 r <br /> CONTRACTOR ADDR S: STREET /�Ia®S \` }iI�ti Ii) W. <br /> ciTY�je� V STATE m N <br /> CONTRACTOR PHONE: v v V 1(_ CONTRACTOR EMAIL: 1 <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED) Q11 11 / <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR ®OTHER(Please Specify) Smartlink LLC on behalf of Sprint <br /> CONTACT NAME: Nancy Sears CONTACT PHONE: 425.444.1434 <br /> CONTACT EMAIL: nancy.sears@smartlinkllc.com <br /> BUILDING;PERMIT APPLUCATION <br /> Existing Use of Building: Crown monopole Contract Price of Work:$ 20,000 <br /> Proposed Use of Building: n/a Heat Source: ❑Gas Electric El Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached El Duplex ❑Multi-Family-#of Units: ®Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ®Remodel El Repair ❑T.I. ❑Sign ❑Sprinkler ODemolition ❑Change of Use <br /> DESCRIPTION OF WORK: Modification to existing wireless communications facility on an Crown monopole-Remove 6 antennas,install 3 tri- <br /> band <br /> r-band antennas and 3 remote radio units(RRUs). <br /> ASSOCIATED BUILDING PERMIT#(if applicable): Previous BP#81403-005 <br /> MECHANICAL PERMIT APPLICATIO • PLUMBING:PERMIT APPLICATION ;'; <br /> Type of Project: _New _ Addn Alteration epair Type of Project: _New Addn Alteration _Repair <br /> #of List of Fixtures #of st of Fixtures #°f List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtu <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink& ; sposal - Grease Trap <br /> Gas Range Ducting Dishwasher; I r i s <br /> Clothes Dryer ookups Other: Clothes • asher ` LMedib °r <br /> Range Hot. Wate eater Ot1i : f� <br /> Exhaus an Si, (Service/Bar/Mop c. orrOther: 11 ) <br /> 1 2017llif <br /> SP N. KLER/'SUPPRESSION SYSTEM ' C T <br /> Chemical or Water I INo.of Heads £ r it <br /> -r <br /> ACKNOWLEDGEMENT:1 have reviewed this application and confirm the information contained herein is true and correct.Work done pursuers 6lt�9, must comply with <br /> current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorllel?in writing from the <br /> Building Official before being authorized under any circumstance.lam the owner,or lam authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> J City of Everett Official Use Only <br /> /f9a %t� iadt.� PERMIT{ �rm 2 <br /> 11/30/17 `� <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />