Laserfiche WebLink
1 PERMIT APPLICATIOI` <br /> ,0 BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER t DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps©everettwa.gov I www.everettwa.gov/permits <br /> tOfWiiiin****OSti***tngngirO*04Ekt <br /> **EltStORMOIWIRROMMEMOINIMEVAMEM <br /> PROJECT SITE ADDRESS: 2215 Merrill Creek Pkwy Everett 98203 PROPERTY TAX it: 280402-003-003-00 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> Ctiou—o NFORMAtI,1 , <br /> OWNER NAME: Polo Properties TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3020 Issaquah Pine Lake Rd SE #55 <br /> crry Sammamish STATE WA ZIP 98075 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAM : TBD Ab 04 C V9 (.01/11110A.I IAil-014 <br /> CONTRACTOR AD KESS: TREET <br /> are STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED) u t1 -3 C 1 w4 CITY OF EVERETT BUSINESS LICENSE#(REQIRED) 470, <br /> PRIMARY CONTACT: El OWNER 0 CONTRACTOR LSI OTHER(Please Specify) Agent <br /> CONTACT NAME: Sprint- Torn Spaulding CONTACT PHONE: 650.380.3140 <br /> CONTACT EMAIL: torn.spaulding@selectsiteacq.corn <br /> :;, .,.. .. . ,BUILDING PERMI A PLICATIO .^ . ,..,. .: <br /> Existing Use of Building: Communications Tower Contract Price of ork:$ 6000.00 <br /> Proposed Use of Building: Swap (3) antennas Heat Source: ►i Gas ❑Electri ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Uni . IBCommercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Sprint is proposing to remove and replace (3) panel antennas <br /> Add (4) RRU and (4) power and fiber junction cylinders. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT:APPLICATILi `:_ PL MBINt PERMIT APPLICATIOt. ; <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: New Addn Alteration Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC-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&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> �Qyy�Exyhaust Fan -�y� �+ +� Sink(Service/Bar/Mop/etc.) Other: <br /> ,�,. .,SPR`N '}ER/StJ P ESSIQN SVSTEMe <br /> Chemical or Water I iNo.of Heads <br /> 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 <br /> 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 <br /> Building Official before being authorized under any circumstance.lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PE [ rrW ' 065 c:1,14_71m- i <br /> Owner/Authoriz= .e e, Signature Dat (Revised 9/23/2016) <br /> Y <br />