2215 MERRILL CREEK PKY CINGULAR WIRELESS ANTENNA 2019-02-11

grrPERMIT APPLICATION BUILDING , MECHANICAL/ PLUMBING /SIGN / JI RINKLER/ 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 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 2215 Merrill Creek PKWY PROPERTY TAX#: 28040200300300 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: Polo Properties LLC TENANT NAME(If Commercial): New Cingular Wireless PCS, LLC. OWNER MAILING ADDRESS: STREET 3248 Hunts Point Road CITY Bellevue STATE WA ZIP 98004 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): GENERDI927CG CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):054962 PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR 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 BUILDING PERMIT APPLICATION Existing Use of Building: Unmanned Wireless Communications Facility Contract Price of Work:$25,000.00 Proposed Use of Building: Unmanned Wireless Communications Facility Heat Source: ❑Gas ❑Electric ['Other N/A Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition I✓7Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: AT&T is proposing to upgrade the existing mount, replace three existing panel antennas, replace three RRH units, and add three RRH's units on the existing monopole. No increase in height or ground ;disturbance. 61603-059 MECHANICAL PERMIT APPLICATIONN/A( PLUMBING PERMIT APPLICATION Type of Project: _New Addn _Alteration Reps r r Type of Project: New Addn _Alteration _Repair N/A L #of List of Fixtures #of List of Fixtures #of List of Fixtures #°{ 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 Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/ SUPPRESSION SYSTEM Number 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 4a-e/ig PEf�idl T, <>oOZ - 030Owner/Aot &gent Signature ate (Revised 9/23/2016)