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PERMIT APPLICATION <br /> BUILDING /MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> I��'/—'41 <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:2215 Merrill Creek Parkway PROPERTY TAX#: 28040200300300 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Polo Properties LLC TENANT NAME(If Commercial): T-Mobile <br /> OWNER MAILING ADDRESS: STREET 3248 Hunts Point Rd <br /> CITY Bellevue STATE WA ziP 98004 <br /> OWNER PHONE: q OWNER EMAIL: <br /> CONTRACTOR NAME: ����1 .If`! <br /> 4 <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: (CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED):�'� I u)`$S rZ2,,AITY OF EVERETT BUSINESS LICENSE#(REQUIRED):\(3 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR JO OTHER(Please Specify) applicant <br /> CONTACT NAME: CONTACT PHONE:858-754-2151 <br /> Jessic Gantzert CONTACT EMAIL: jgantzert@md7.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Telecom Contract Price of Work:$ 25,000.00 <br /> Proposed Use of Building: telecom Heat Source: ❑Gas DElectric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: $7 Commercial ❑Industrial <br /> Type of Project: ❑New [Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Replace 2 RRU,add 1 RRU <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of #of #of #of <br /> List of Fixtures List of Fixtures List of Fixtures List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <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 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 /> Exhaust Fan _ Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water ' 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.I am 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 /> 4 PERMIT '�os-D.3I <br /> 8/17/17 <br /> Date <br /> 0 r/Authorize nt Sign toe (Revised 9/23/2016) <br />