2520 MADISON ST SPRINT ANTENNA 2019-03-28

II• II II PERMIT APPLICATION IiI hII BUILDIN*I4 /PLUMBING /SIGN J MINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: adison Street, Everett, WA 98203 PROPERTY TAX#: 002758634 LEGAL for new construction: Short Plat/subdivision 2520 Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: American Tower Company TENANT NAME(If Commercial): Sprint OWNER MAILING ADDRESS: STREET 116 Huntington Avenue CITY Boston STATE MA ziP 02116 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: TBD-out for bid CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR I7 OTHER(Please Specify) agent for Sprint CONTACT NAME: CONTACT PHONE: 858-754-2151 Lorelei Foronda CONTACT EMAIL: Iforonda@md7.com BUILDING PERMIT APPLICATION Existing Use of Building:Unmanned telecommunication facility Contract Price of Work:$ 50,000 Proposed Use of Building: Unmanned telecommunication facility Heat Source: OGas DElectric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: L7Commercial ❑Industrial Type of Project: ONew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Modify existing telecommunication facility as depicted on page T-1 of the construction drawings. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration Repair Type of Project: _New _Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of fust of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures NC—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 'Chemical or Water I INo.of Heads ACKNOWLEDGEMENT.:l 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 F - / (-2-1 l t) PERM' TBVCljn Owner/Authorized Agent Signature Date (Revised 9/23/2016)