5828 GLENWOOD AVE CINGULAR WIRELESS ANTENNA 2020-12-29

PERMIT APPLICATION BUILDING I MECHANICAL/PLUMBING /SIGN/SPRINKLER/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:5828 Glenwood Avenue PROPERTY TAX#: 28040100201200 LEGAL for new construction: Short Plat/subdivision see legal sheet T1 dwgs Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Public Utility Dist 1 Sn0 Co (SnoPud) TENANT NAME(If Commercial): New Cingular Wireless PCS, LLC. OWNER MAILING ADDRESS: STREET 2320 California Street CITY Everett STATE WA ZIP 98201 OWNER PHONE: 425-783-1000 OWNER EMAIL: CONTRACTOR NAME: General Dynamics Info Tech CONTRACTOR ADDRESS: STREET 19240 Des Moines Memorial Drive South Suite 300 cnv SeaTac STATE WA ZIP 98148 CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): GENERDI927CG CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):054962 PRIMARY CONTACT: ❑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 BUILDING PERMIT APPLICATION Existing Use of Building: Unmanned Wireless Communications Facility Contract Price of Work:$20,000.00 Proposed Use of Building: Unmanned Wireless Communications Facility Heat Source: ❑Gas ❑Electric DOther N/A Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition IZIRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use _ DESCRIPTION OF WORK: Replace(3)existing antennas,(3)RRH units,add(3)RRH units,and remove and or replace associated ancillary equipment on an existing pole. ASSOCIATED BUILDING PERMIT#(if applicable): B1612-016 MECHANICAL PERMIT APPLICATIONIN/A t PLUMBING PERMIT APPLICATION Type of Project: _New_ Addn _Alteration Repair Type of Project: _New _Addn _Alteration _Repair IN/A L #of List of Fixtures #of List of Fixtures #of List 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 ShowerFloor 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/SUPPRESSIOTEM Number of Heads NIA 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.t 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 Officials Use Only 3/19// PER \ct0.�`V JV Owners orized AgentSigna Date -'= (Revised 9/23/2016) r�y