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-4., II II SE54XC102 <br /> c. PERMIT APPLICATIOIt— <br /> 4/-11 --AVI" <br /> BUILDING/MECHANICAL/PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 9610 19th Ave SE PROPERTY TAX#: 28051800406500 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Premier Storage Everett LLC TENANT NAME(If Commercial): Sprint <br /> OWNER MAILING ADDRESS: sTREET5729 Lakeview Dr NE <br /> cir, Kirkland STATE WA zip 98033 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: TBD I l C 11 G 4as LW <br /> CONTRACTOR ADDRESS: STREET C) Metel A coo 4- . 11,00 (1on/ <br /> , , ,,,r <br /> CITY OhI( STATE ZIP b06tpI <br /> CONTRACTOR PHONE: 1 O t/ CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED):SA C 1'vV Ii 5 2 S 2 CITY OF EVERETT BUSINESS LICENSE#(REQUIR ): 23�` ) <br /> VV <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR ®OTHER(Please Specify) Smartlink LLC on behalf of Sprint <br /> CONTACT NAME: Nancy Sears CONTACT PHONE: 425.444.1434 <br /> ( V® VI 1 Oki) CONTACT EMAIL: nancy.sea . • art klIc.com <br /> BUILDING PERMIT APPLICATION'" <br /> Existing Use of Building: SBA Monopole on a public storage site Contract Price of Wor :$ 20,000 <br /> Proposed Use of Building: n/a Heat Source: ❑Gas DElectric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex •. ulti-Family-#of Units: e Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ®Remodel ❑Reps' ■T.I. ❑Sign ❑Sprinkler 0 D • ion ❑Change of Use <br /> DESCRIPTION OF WORK: Modifi : ion to existing wi - -ss communications facility on an SBA - .nopole-Remove and replace 3 antennas, <br /> install 6 remo - units(RRUs).' `/ea ,`t <br /> applicable : A <br /> ASSOCIATED BUILDING PERMIT : a : - �� �.= "=;";; Le I CI V �) . - '- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of 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 I No.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 I co..ly with the State Contra.ors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> I � � � .1 � PERMIT# <br /> 4 l l -023 <br /> No Own- /Au •rized Agent Si a ate (Revis�d'g/23/2016) <br /> 41112— <br /> F <br />