906 SE EVERETT MALL WAY A T AND T MOBILITY ANTENNAS 2020-10-14

PERMIT APPLICATION BUILDING /MECHANICAL/PLUMBING/SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES ,s 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 Onl Pieese' Y )' . iiwRo.IECT sirWINfORMATIc 4 = PROJECT SITE ADDRESS:906 SE Everett Mall Way PROPERTY TAX#: 28051800308500 LEGAL for new construction: Short Plat/subdivision see legal sheet A-1 dwgs Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: PFLUEGER-EVERETT HOLDINGS LLC TENANT NAME(If Commercial): New Cingular Wireless PCS, LLC. OWNER MAILING ADDRESS: STREET 601 Union Street#5300 CITY Seattle STATE WA ZIP 98101 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: General Dynamics Info Tech CONTRACTOR ADDRESS: STREET 19240 Des Moines Memorial Drive South Suite 300 CITY SeaTac STATE WA ZIP 98148 CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): GENERD1927CG CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):054962 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR ZI OTHER(Please Specify) Authorized Agent CONTACT NAME: CONTACT PHONE: 0: 206-523-1941 /M: 425.351.3392 Christine Contreras, on behalf of AT&T CONTACT EMAIL:ccontreras@rykaconsulting.com 3 BUILDING:PERIR1T5PRLICATIW-'',,. F Existing Use of Building: Unmanned Wireless Communications Facility Contract Price of Work:$ Ajei DDO Proposed Use of Building:Unmanned Wireless Communications Facility Heat Source: ❑Gas ❑Electric ❑Other N/A Building Type: ❑SFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition QlRemodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Replace three panel antennas, install six remote radio heads and three Surge Suppression units on an ii existing rooftop wireless facility. No increase in height or ground disturbance. ASSOCIATED BUILDING PERMIT#(if applicable): B1610-032 . MECHANICAL PERMIT APPLICATION N/A ' PLUMBING PERMIT,APPLICATION Type of Project: _New _ Addn _Alteration _Repain. Type of Project: New _Addn _Alteration _Repair N/A J Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of 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 Sink(Service/Bar/Mop/etc.) Other: SPRINKLER I SUPPRESSIfl. TEM INumber of Heads N/A 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 co " he State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Officinal Use Only /� k /r ✓L PERMIT# 61-71C� ' V� 1 /j Ownerf&,pttr07izedAgent Signature Date (Revised 9/23/2016)