2408 39TH ST T MOBILE ANTENNA 2019-08-08

Pr grr PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 l 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: 2408 39TH ST. EVERETT,WA 98201 PROPERTY TAX#: 00576003200011 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) See T-1 Construction Drawings CONTACT INFORMATION OWNER NAME: Jack Sheeler TENANT NAME(If Commercial): T-Mobile,submitted by Andi Saxton OWNER MAILING ADDRESS: STREET 8919 Eastview Ave.,Everett,WA 98208 Crown Castle CITY STATE ZIP OWNER PHONE: 206-336-2867 OWNER EMAIL: andi.saxton@crowncastle.com CONTRACTOR NAME: SAC Wireless LLC CONTRACTOR ADDRESS: STREET 540 MADISON STREET, 16TH FLOOR CITY CHICAGO, IL 60661 STATE ZIP CONTRACTOR PHONE: 847-9444600 CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): SACWIWL852J2 CITY OF EVERETT BUSINESS LICENSE#(REQUI ED):6U PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR El OTHER(Please Specify) Agent CONTACT NAME: CONTACT PHONE: 206-336-2967 Andi Saxton,Crown Castle, on behalf of T-Mobile CONTACT EMAIL: Andi.Saxton©crowncastle.com BUILDING PERMIT APPLICATION Existing Use of Building: Existing 130 ft.Monopole Contract Price of Work:$ 25,000 Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: IICommercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ®T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 6409 Eligible Facilities Request TMobile proposes to replace(9)antennas;add(3)RRUs; replace(1)hybrid cable; add(1)COVP. No changes to ground space. 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 #ofList 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 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 I SUPPRESSION SYSTEM Chemical or Water I No.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 PERM \ Ll(` OJ 09/18/2018 .� Owner/Authorized Agent Signature Date (Revised 9/23/2016)